Index
It is an outlet for artificially created bladder fluid.
Urinary drainage is done here through the abdominal wall. The operation in which an artificial bladder outlet is created is called a urostomy.
Installing a urostomy can be a temporary or permanent solution.
Why is a urostomy necessary?
There are various reasons why a urostomy may be necessary, all of which are due to a defect or problem with the urinary system, which must be eliminated or avoided.
For some types of cancer, the bladder will need to be removed.
Babies are sometimes born with urinary tract defects. For example, in spina bifida, the function of the bladder and urethra are affected.
In conditions such as multiple sclerosis, cerebral palsy, and spinal injury, nerve damage will occur, leading to bladder dysfunction.
Incontinence problems can also arise from gynecological problems, a urinary fistula (a pathway to the ureter or bladder), or other problems that prevent the bladder and sphincter muscles from working correctly.
A condition such as painful bladder syndrome or interstitial cystitis may require a urostomy.
Some people choose a urostomy for social reasons because it is easier to manage than a defective bladder. With this condition, patients cannot control urine flow, causing embarrassment and problems with the skin because it is constantly wet.
Thousands of people have discovered how good life is after surgery and are now seeking an active and rewarding life. Many people consider that this operation has given them a “new life.”
Characteristics and function of the stoma
A healthy stoma is moist and red, just like the inside of your mouth. The piece of intestine that has been used in surgery produces mucus to lubricate the lining, to help the passage of stool through the intestine.
Therefore, the duct will also produce mucus visible in the urine as a whitish, jelly-like substance. This is quite normal and can decrease over time.
Because the stoma does not have nerve endings, it has little sensation and is not painful when touched. However, a rich blood supply near the surface explains why the stoma sometimes bleeds when cleaned.
This is not a concern, but it reminds you to handle your stoma with care.
Sometimes the stoma can be seen to move; this is the normal contractile movement of the intestine, which now helps direct urine into the urostomy bag.
Urostomy bags
There are a wide variety of urostomy bags available, made by many manufacturers. All bags are waterproof, odor-proof, and have skin-friendly adhesives, which protect the skin around the stoma.
The bags are equipped with a check valve, which prevents the urine in the bag from flowing back over the stoma.
All bags have taps or plugs on the bottom that allow urine to drain into the toilet when the load is filling, leaving the bag in place to continue collecting urine.
The two-piece pouches consist of an adhesive tab fitted to the abdomen around the stoma, and a pouch, which is then attached to the account.
With this system, the harness can remain in the abdomen for 3 to 5 days, only needing to change the bag.
One-piece systems comprise a bag with the adhesive sealed directly over it. They can be left on the skin for 1 to 3 days before the entire system needs to be changed.
Both types are available in a range of sizes precut or with a starter hole that can be cut to fit individual stomata. The precut option is helpful once the stoma has retained a regular shape.
Gastroscopy bags and other essential stoma care items are available by prescription. Individuals under the age of 60 will need to complete an exemption form.
What urostomy procedures are there?
In Germany, ileum duct gastroscopy and ureteral skin fistula are mainly used for artificial urinary diversion.
Ureteral fistula
In the case of a ureteral skin fistula, the surgeon connects the two ureters in the abdominal cavity and then guides the longer one through the abdominal wall. Again, using thin catheters to keep the urethra open makes sense; the wound heals.
Ileum duct
The doctor will adapt a portion of the small intestine when treating it with an ileal conduit. In this, you sew the two ureters together and close one end of the small intestine piece blindly.
Direct the other end outward over the patient’s abdominal wall. Therefore, urine is excreted from the ureters onto the disused intestinal part.
Usually, a thin catheter is placed into the draining urethra (splint) so that it cannot be narrowed. This is removed once the wounds have healed.
Mitrofanoff stoma
In a Mitrofanoff stoma urostomy, the abdominal surgeon removes the cecum and connects it as a channel between the bladder and the abdominal wall.
What problems can occur with a urostomy?
Common problems experienced by urostomy patients are:
- Formation of urinary stones.
- Urinary tract infections
- Urinary obstruction, possibly with kidney damage.
There are also some risks to consider when creating the urostomy itself.
This includes:
- Injury to nearby organs.
- Nerves and blood vessels.
- Wound healing disorder.
- Cicatrization.
- Fracture of the abdominal wall (hernia).
Living with a urostomy
What should I consider?
An artificial bladder outlet requires meticulous care to prevent infection. Remember to empty the bag when it is about a third full. Even with lower excretion levels, you should change the bag daily for hygiene reasons.
Otherwise, there is a risk that it will otherwise come out of the skin under its weight. When cleaning the skin around the artificial bladder outlet, use warm water and a clean cloth or low-germ disposable wipes.
Hair in the common area of your urostomy pouch should be removed regularly.
