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Urostomy Creation

AMBULATORY CARE:

What you need to know about urostomy creation:

Urostomy creation is surgery to create a new way for urine to drain from your body. This may be needed if your bladder is not working correctly or was removed, such as for cancer treatment. A part of the small intestine called the ileum is used to create an opening on your abdomen called a stoma. Urine will leave your body through the stoma. The urine will either be stored in the ilium or flow into a pouch. This depends on the kind of surgery you have.

Urostomy

How to prepare for surgery:

  • Your surgeon will tell you how to prepare for surgery. He or she may tell you not to eat or drink anything after midnight on the day of your surgery. Arrange for someone to drive you home when you are discharged. Ask the person to stay with you for 24 hours.
  • Tell your surgeon about all medicines you currently take. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
  • Tell your surgeon about all your allergies, including anesthesia and medicines. You may be given antibiotics to take for a few days before surgery to prevent infection.
  • Healthcare providers will find the best place for the stoma to be created. You may be given a sample pouch to wear. Healthcare providers will ask you to do your normal activities while you wear the pouch. This will help make sure it is in the best place.

What will happen during surgery:

  • You will be given general anesthesia to keep you asleep and free from pain during surgery. Your surgeon will cut out a small piece of the ileum. He or she will reconnect your intestines so they will work correctly. One end of the ileum will be guided through your abdomen to make the stoma. Your surgeon may do any of the following, depending on the kind of urostomy you are having:
    • For a standard urostomy, your ureters will be removed from your bladder. Your surgeon will attach the ureters to the ileum. This will make urine flow directly to the ilium. A pouch will be attached to the stoma. Urine will flow from the ilium through the stoma and into a pouch. You will wear the pouch at all times and empty it regularly.
    • For a continent urinary reservoir, your surgeon will use the ilium to create a pouch inside your body. Urine will stay in the pouch until you drain it through the stoma. You will use a catheter (thin tube) to drain urine about 4 or 5 times each day.
  • Your surgeon will check for leaks. He or she will make sure urine is flowing correctly through the new system.

What to expect after surgery:

You may need to stay in the hospital for 3 to 5 days after surgery.

  • You may be given pain medicine for a few days after surgery. You may also be given antibiotics to prevent or fight an infection.
  • You will be helped to walk around after surgery to help prevent blood clots.
  • Your urine may be pink or red for a time after surgery. This is normal and should get better soon.
  • You will meet with a urostomy or stoma care specialist while you are in the hospital. You will be shown how to care for the stoma and the skin around it. You will also learn how to empty the pouch and how to use a night drainage system while you sleep. You may need to measure your urine at home every time you empty it.
  • You may see some mucus in the pouch along with your urine if you have a standard urostomy. This is normal.

Risks of urostomy creation:

Scar tissue may form in your abdomen and cause a bowel blockage. You may have trouble controlling urine. You may have bowel movements more often than before surgery, or you may have diarrhea. Bacteria may get into the urostomy and cause a urinary tract infection.

Seek care immediately if:

  • You cannot stop the bleeding from your stoma.
  • You have severe abdominal pain.

Call your doctor or surgeon if:

  • You have a fever.
  • You have blood in your urine, and your urine has a strong odor.
  • Your incision wound or stoma is red or swollen, or you have a rash.
  • You have nausea, bloating, pain, or are vomiting.
  • You empty less than 30 mL of urine from your pouch per hour or less than your healthcare provider said you should.
  • Your stoma changes in size or appearance.
  • You are weak and unable to do your normal activities.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Antibiotics may be given to prevent or treat a bacterial infection.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Self-care after urostomy creation:

  • Care for the skin around your stoma. Wash your hands before and after you care for your stoma. This will help prevent infection. Wash the stoma and the skin around it with mild soap and water. Rinse the area well and pat dry. Do not rub on the stoma. Check the skin for signs of infection, such as redness, swelling, or pus. Ask for more information on stoma care.
  • Go slowly and be careful after surgery. You will need to limit your activities for the first 2 to 3 weeks after surgery, or as directed. Do not lift anything heavy. Ask your healthcare provider when you can return to your normal activities and sports. Contact sports, such as football, may not be safe for you even after you heal from surgery.
  • Ask when you can take a bath or shower after surgery. You can leave the pouch on or take it off when you bathe. If you leave the pouch off, urine may leak out of the stoma while you bathe. Carefully dry the skin around the stoma and apply new skin protection.
  • Drink liquids as directed. Your healthcare provider will tell you how much liquid you should drink each day.
  • Return to work when your healthcare provider says it is okay. You may need support to prevent a hernia if you lift heavy items or perform heavy labor. You may need an ostomy belt over the pouch to keep it in place.
  • Carry extra supplies with you in case your bag leaks. Supplies include extra pouches, skin protection products, and a change of clothing. Wear loose clothing so it will not rub against the stoma.

Follow up with your doctor or surgeon as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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