Urostomy

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What is a urostomy?

A urostomy is an opening in the belly (abdominal wall) that is made during surgery. It re-directs urine away from a bladder that is diseased or not working as it should. The bladder is either bypassed or removed. (Surgery to remove the bladder is called a cystectomy.) The urine is passed out of the body through an opening called a stoma. An enterostomal therapy (ET) nurse or the surgeon will figure out the best location for your stoma. (An ET nurse is a specially trained registered nurse who takes care of and teaches ostomy patients. This nurse may also be called a Wound, Ostomy and Continence nurse (WOC) or an ostomy nurse.)

The stoma will look pink to red and will be moist and shiny. The shape will be round to oval, and it will shrink over time after surgery. Some stomas may stick out a little, while others are flush with the skin.

You will not be able to start and stop urine coming out through the stoma, so a pouch will be fitted to collect the urine as it comes out. There are no nerve endings in the stoma, so it is not a source of pain or discomfort.

Getting ready for surgery

As you get ready for abdominal surgery, your doctor or your ostomy nurse will explain the process and look at your abdomen to find the best location for the stoma. You may be asked to wear a sample pouch to make sure that the place chosen is on the flattest possible surface and that you are comfortable in all positions. If you have any hobbies or habits that might be affected by the placement of the pouch, talk to the doctor or the ostomy nurse.

A special source of help is an ostomy visitor. The visitor is a person who has a urostomy and has adapted well to the changes that it brings. He or she can answer many of your questions about day-to-day life. You may also find it helpful to take part in an ostomy support group. A support group allows you to share your feelings and ask questions as you recover and adjust to your urostomy. You can also share your story with others who may be helped by your experience.

Why have a urostomy?

Urostomy surgery is done for some diseases and conditions that cause serious bladder problems. The bladder is part of the urinary tract – the system that removes liquid waste products from the body. The urinary tract is made up of 2 kidneys, 2 ureters, the bladder, and the urethra. Urine is made in the kidneys. It flows through the ureters to the bladder for storage. It passes out of the body through the urethra. You can live without a bladder, but you must have a certain amount of kidney function to grow and be healthy.

If there is cancer (a malignancy) in the bladder, all or part of the bladder may be removed and the urine detoured through a urostomy. This may cure the cancer.

Some people find a urostomy easier to manage than a defective bladder that may have been caused by something like a birth defect, surgery, or spinal injury. Bladder problems often mean that people cannot control the flow of urine – they are incontinent. This can be embarrassing and the constant wetting may cause skin problems. Some young people have even asked for urostomy surgery as a way to end this problem.

Some children are born with a defect in the urinary tract that causes urine to back up into the kidneys. This leads to chronic or repeat infections. For these children, a urostomy may be life-saving. Surgery can make a pathway through which the urine may travel easily, without any blockages (or obstructions) that cause it to back up. This allows the kidneys to work their best.


Last Medical Review: 03/17/2011
Last Revised: 03/17/2011