Urostomy

A urostomy is a surgical procedure that diverts urine away from a diseased or damaged bladder. It involves creating a new opening in the abdomen, called a stoma, through which urine exits the body. This procedure is typically performed when the bladder is no longer functioning properly due to conditions such as bladder cancer, spinal cord injury, congenital disabilities, or chronic inflammation.

During a urostomy, a section of the small intestine (ileum) or, less commonly, the large intestine (colon) is surgically removed. This section of bowel is then reconfigured to create a conduit or pouch to hold the urine. The ureters, which carry urine from the kidneys, are connected to this newly formed conduit or pouch. One end of the conduit or pouch is brought through the abdominal wall to form the stoma.

There are two primary types of urostomies:

• Ileal Conduit: This is the most common type of urostomy. In this procedure, a short segment of the ileum is used to create a conduit. The ureters are attached to this segment, and urine flows continuously through the conduit and out the stoma. The patient must wear an external collection pouch to collect the urine.

• Continent Urostomy (Continent Cutaneous Reservoir): In this procedure, a larger section of the intestine is used to create an internal pouch. The ureters are connected to the pouch, and a valve mechanism is created to prevent urine from flowing out of the stoma continuously. The patient empties the pouch several times a day by inserting a catheter into the stoma. This type of urostomy eliminates the need for an external collection pouch.

After a urostomy, patients require education and training on how to care for their stoma and manage their urine output. This includes learning how to empty or catheterize their pouch (if applicable), change their appliance (if using an external pouch), and monitor for complications such as skin irritation, infection, or blockage. Regular follow-up with a healthcare provider is essential to ensure proper function and address any potential issues.