Managing your urostomy

Learning to take care of your urostomy may seem hard at first, but with practice and time it will become second nature, just like shaving or bathing.

Emptying the pouch

The urostomy pouch has a drain valve at the bottom, so it can be emptied as needed. Since bacteria grow quickly in urine, it’s important to empty the pouch often, at regular times. A lot of urine in the bag also could damage the pouch seal. It’s a good idea to empty your pouch when it’s about 1/3 to 1/2 full.

During the day most people need to empty the pouch about as often as they used the bathroom before they had urostomy surgery or other bladder problems – for many people, this might mean every 2 to 4 hours, or more often if you drink a lot of fluids. Children may have to empty more often because their pouches are smaller. Follow these steps:

  • Sit as far back on the toilet as you can.
  • Place a small strip of toilet paper in the toilet to decrease splashing.
  • Hold the bottom of the pouch up and open the valve.
  • Gently empty the contents right into the toilet.
  • Close the valve.
  • Dry the end of the valve with toilet paper.

At night a piece of flexible tubing can be attached to the drain valve on your pouch. This allows the urine to flow into a bigger bedside bag while you sleep. Many people find a bedside drainage unit better than getting up during the night to empty the pouch. (This is discussed later in “Using a night drainage system.”)

Changing the pouch

Different pouching systems are made to last different lengths of time. Some are changed every day, some every 3 days or so, and some just once a week. It depends on type of pouch you use.

Your pouch should be changed on a schedule that fits your routine. In other words, don’t wait for it to leak to change it. It may be easier to change the pouch in the morning before you eat or drink anything. If this isn’t a good time for you, try to wait at least 1 to 2 hours after drinking fluids so that urine doesn’t get on your skin and supplies while you change the pouch.

You’ll want to find the best position for putting on your pouch – sitting, standing, or lying down. The position you use should allow you to see your stoma and be easy for you to be in when making a change. Some people stand facing the toilet so the urine dripping from the stoma falls in the toilet. When changing while sitting in a wheelchair, it’s helpful to slide your buttocks toward the front of the chair and lean back a little. Using a mirror may help you center the pouch over the stoma.

Before changing your pouch, clean your hands well and put all your supplies on a clean surface. Clean pouches decrease the chances of germs (bacteria) getting into your urinary system. Bacteria can multiply quickly even in the tiniest drop of urine. These germs may travel up the ureters and cause a kidney infection. Bacteria can also cause foul-smelling urine. Some people find it helpful to use rolled tissues, paper towels, or tampons to absorb dribbling urine from the stoma.

You don’t have to use sterile supplies – the stoma and nearby skin are clean, but not sterile. But keeping all your supplies clean and organized will save you time and money. Always have at least 2 complete pouches, one on your body and one ready for your next change (see Ordering and Storing Urostomy Supplies).

At first you may find that changing your pouch can take up to 30 minutes. With time and practice you may be able to change it in 10 minutes or less.

Factors that can affect the pouching system seal

The pouching system must stick to your skin. It’s important to change it before it loosens or leaks. The length of time the pouch stays sealed to the skin depends on many things, such as proper fitting, the weather, skin condition, scars, weight changes, diet, activity, and the shape of your body near the stoma.

Here are some other things that may affect how long a pouch sticks:

  • Sweating will shorten the number of days you can wear a pouch. Body heat, added to outside temperature, will cause skin barriers to loosen more quickly than usual.
  • Moist, oily skin may reduce wearing time.
  • Weight changes will affect how long you can wear a pouch. Weight gained or lost after urostomy surgery can change the shape of your abdomen. You may need an entirely different system.
  • Physical activities may affect wearing time. Swimming, very strenuous sports, or anything that makes you sweat may shorten wearing time.

Using a night drainage system

At night the bottom of the pouch can be connected to a night drainage system which carries urine away from the stoma while you sleep. This lets you sleep undisturbed. Gravity drains the urine to a bedside container. This keeps your pouch from getting so full and heavy that it pulls away from your body. It also protects your stoma and skin against the build-up of strong urine.

Illustration showing a night drainage system which carries urine away from the stoma while you sleep.

When connecting the pouch to the bedside drainage bag, leave a small amount of urine in the pouch before attaching the tubing. This keeps you from setting up a vacuum in the system. The bedside container should be vented and the tubing should be secured at the top of the bag or bottle with no more than one inch of it going down into the bag or bottle. If the urine backs up into the tubing it will stop draining. The drainage container can be hung on the side of the bed, or put in another container on the floor. A small wastebasket may be used for this purpose.

Clean the tubing and beside drainage collector every morning. Pour about 2 ounces of a vinegar-and-water solution into the emptied pouch that’s attached to the night drainage system. (Use 1 part of white vinegar to 3 parts of water.) Let it run out of the pouch, through the tubing, and into the collection container. Then pour it out and hang up the night drainage tubing so it can air dry.

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:

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: December 2, 2014 Last Revised: December 2, 2014

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