Having a urostomy
Everyday life
The medical team will prepare you for surgery and provide the necessary information. The nurses taking care of you after the surgery will do their best to instruct you how to manage the stoma after returning home. Before leaving the hospital you will probably receive a kit containing, among other things, a sample of urostomy equipment, i.e. a demonstration sample of the medical device for educational purposes. Remember that proper selection of urostomy care supplies is very important. You have the right to freely decide what urostomy care supplies you are going to use.
Where is the urostomy located on your body?
A surgical urostomy is usually created on the right side of the patient’s abdomen. Before the surgery, the medical personnel will discuss with you the most convenient and medically feasible urostomy location. The planning process will take into account various factors such as your lifestyle, individual preferences, and even your preferred style of dress. A special pouch will be attached to the skin around your stoma at all times.
Surgery
How is urostomy created?
A urostomy is the general name of the connections made between the urinary tract – i.e. the renal pelvis, ureters or bladder and the skin – to ensure the urinary outflow from the urinary tract to the outside. There is no linguistic distinction between surgically formed fistulas (that include stomas) and spontaneously formed fistulas (fistulas). This chapter deals with the former, and the terms: urinary fistula – stoma – urostomy are used synonymously here.
A urostomy can be created temporarily when there is a probability of restoring the physiological urinary tract, or permanently, when it is not possible to restore the physiological pathway.
The removal of urine from the urinary tract can also be achieved by inserting a catheter into it – through the abdominal wall, after percutaneous puncture of the dilated renal pelvis or bladder. These fistulas are usually created for a certain period, but in some patients, they must be used permanently. Appropriate medical device kits are used to create a temporary urinary fistula using the percutaneous puncture method. Permanent fistulas are usually created using an isolated intestinal loop, forming a conduit, the distal end of which is fused with the skin opening of the fistula, and the other end has ureters implanted into it. The indications for the creation of temporary fistulas, usually performed using the puncture method, are the conditions that lead to urine stagnation in the urinary tract, requiring immediate unblocking of the urinary system. A permanent urostomy is usually performed due to the necessity of removing the bladder (cystectomy) due to infiltrating bladder cancer. The method of discharging urine is selected individually for each patient and depends on specific conditions, such as the existing disease, the progression of possible cancer, assessment of urine output, and the degree of upper urinary tract damage. The most common indication for fistula creation are neoplastic diseases of the bladder, prostate or genital tract, as well as lesions caused by irradiation, i.e. radiation-induced vesicovaginal fistulas, narrowing of the ureters or radiation-induced bladder fibrosis. Less frequently occurring fistulas are due to neurogenic bladder dysfunction or post-operative complications. The continuous development of surgical techniques and the search for new solutions regarding the tightness of fistula care supplies have made it possible to reduce the incidence of complications associated with the functioning of urostomy. The creation of a urinary-cutaneous fistula does not guarantee the correct course of rehabilitation alone. The patient should accept a new image of their own body, learn the principles of fistula care and the method of its management. Sometimes, it is necessary to work with a psychologist or volunteer. Support from close relatives is very important. You can and even should live normally with a urostomy!
After surgery
When you wake up after the stoma surgery, you will most likely be connected to medical equipment monitoring your condition. In the following days, you will be gradually disconnected from the monitoring devices. The created urostomy will be covered with a transparent pouch. A urostomy can initially be swollen but within a few weeks after surgery, its size will partially decrease.
Urine flowing out of the urostomy immediately after the procedure may be bloody. Over the next 2-3 weeks, the colour of the urine will gradually become paler.
Leaving the hospital
The creation of a urostomy is a major surgery. You will probably remain in the hospital for a few days after the surgery. During this time, the nurse taking care of you will show you how to nurse your urostomy and how to use urostomy supplies. After leaving the hospital, the urostomy supplies will be provided to an insured person free of charge up to the applicable limit.
There are millions of people worldwide living with a stoma – colostomy or urostomy.
Having an artificial stoma is not an obstacle to normal life. It is still possible to realise your passions and enjoy a full life!
Properly selected high quality stoma, urine collection and rological supplies, as well as attentive care and support from qualified personnel will certainly ensure it.