Caring for a urostomy
As you learn more, you may have questions about caring for your urostomy. This section has many tips that come from others. But remember, no two people are alike. There’s no one right answer, only suggestions and ideas for you to try.
Protecting the skin around the stoma
The skin around your stoma should always look the same as the skin anywhere else on your abdomen. But urostomy output can make this skin tender or sore. As you get stronger and get better at handling your equipment, skin irritation may become less of a problem. Here are some ways to help keep your skin healthy:
- Use the right size pouch and skin barrier opening. An opening that’s too small can cut or injure the stoma and may cause it to swell. If the opening is too large, urine could get to and possibly irritate the skin. In both cases, change the pouch or skin barrier and replace it with one that fits well.
- Change the pouching system regularly to avoid leaks and skin irritation. Itching and burning are signs that the skin needs to be cleaned and the pouching system should be changed.
- Do not rip the pouching system away from the skin or remove it more than once a day unless there’s a problem. Remove the skin barrier gently by pushing your skin away from the sticky barrier rather than pulling the barrier from the skin.
- Clean the skin around the stoma with water. This can be done in the shower or tub. Pat the skin dry before putting on the skin barrier or pouch.
- Watch for sensitivities and allergies to the adhesive, skin barrier, paste, tape, or pouch material. They can develop after weeks, months, or even years of using a product because you can become sensitized over time. If your skin is irritated only where the plastic pouch touches it, you might try a pouch cover or a different brand of pouch. Pouch covers are available from supply manufacturers, or you can make your own.
- You may have to test different products to see how your skin reacts to them. If you feel comfortable testing yourself, follow the directions under “Patch testing” that follow. If you’re not comfortable doing this on your own and the problem continues, talk to your doctor or ostomy nurse.
Patch testing can be done to see if you’re sensitive to or allergic to a product used as part of your ostomy care. Place a small piece of the material to be tested on the skin of your belly, far away from the urostomy. If the material is not self-sticking attach it with an adhesive tape that you know you’re not allergic to (Figures 21 and 22). Leave it on for 48 hours.
Gently remove the patch at the end of 48 hours and look for redness or spots under the patch. If there’s no redness after 48 hours, it’s generally safe to use the product. But, in a few cases, reactions that took longer than 48 hours to show up have been reported (Figure 23).
Itching or burning before 48 hours pass is a sign of sensitivity. Remove the material right away and wash your skin well with soap and water.
A reaction to the tape is also possible. If this is the case, the redness or other irritation will only be in the area outlined by the tape (Figure 24).
If you seem to be allergic to a certain product, try one made by another company and patch test it, too. It may take a few tries to find one that works for you. Keep in mind that allergies are not as common as is irritation caused by using a product the wrong way. For this reason, before using a product, always read the directions that come with it. When in doubt, check with your ostomy nurse or doctor.
Spots of blood on the stoma
Spots of blood are no cause for alarm. Cleaning around the stoma as you change the pouch or skin barrier may cause slight bleeding. The blood vessels in the tissues of the stoma are very delicate at the surface and are easily disturbed. The bleeding will usually stop quickly. If it doesn’t, call your ostomy nurse or your doctor.
Urine pH balance
Urine pH is a measure of how acid or alkaline it is. When the food you eat is used by the body, it leaves a mineral residue called ash. This ash can be either acidic or basic (alkaline) depending on the type of food.
Most fruits and vegetables give an alkalinized ash and tend to make the urine alkaline. Meats and cereals usually lead to an acidic ash residue.
Unless you are told otherwise, your urine should be kept in an acid state. Drink cranberry juice in place of orange juice or other citrus juices (these tend to make the urine more alkaline), and take vitamin C daily (check with your doctor first). Some of the acid ash foods include: most meats, breads and cereals, cheese, corn, cranberries, eggs, macaroni, nuts, pasta, prunes, fish, and poultry.
Shaving hair under the pouch
Having a lot of hair around the stoma can make it hard to get the skin barrier to stick well and may cause pain when you remove it. Shaving with a razor or trimming hair with scissors is helpful. Extreme care should always be taken when doing this. It’s recommended that you dry shave the skin around your stoma using a stoma powder, since soap and shaving creams have lotions and oils that may cause the skin barrier not to stick. After shaving, rinse and dry the skin well before applying your pouch.
You can take a bath or shower with or without your pouch in place. If you don’t wear a pouch, keep in mind that urine may keep draining out. Soap will not irritate your stoma, but soap may interfere with the skin barrier sticking to the skin. It’s best to only use water while cleaning the skin around your stoma. If you do use soap, be sure to rinse your skin well. Don’t use bath oil around the stoma – it can make it hard to get the pouch to stick.
If you bathe with your pouch off, be sure your skin is cool and dry before you put on a pouch. Otherwise the heat from a hot bath or shower can keep the skin warm and make you sweat under the barrier, this makes it hard to get a secure seal.
- What is a urostomy?
- How the urinary system works
- Types of urostomies
- Choosing a pouching system
- Managing your urostomy
- Ordering and storing urostomy supplies
- Caring for a urostomy
- Avoiding and managing urostomy problems
- If you are hospitalized while you have a urostomy
- Living with a urostomy
- Telling others about your urostomy
- What to wear when you have a urostomy
- What to eat when you have a urostomy
- Returning to work after urostomy surgery
- Intimacy and sexuality when you have a urostomy
- Playing sports and staying active with a urostomy
- Traveling with a urostomy
- For parents of children with urostomies
- Getting help, information, and support
- To learn more
In its original form this document was written by the United Ostomy Association, Inc. (1962-2005) and reviewed by Jan Clark, RNET, CWOCN and Peg Grover, RNET. It has since been modified and updated by:
Last Medical Review: December 2, 2014 Last Revised: December 2, 2014