June 21, 2016

What is a Urostomy?

By Jeana Scroggins

A urostomy is a urinary diversion is the opening that allows for urine to bypass both the urethra and bladder it is done when there is bladder cancer, chronic inflammation, or a neurological bladder dysfunction, a malfunction of the kidneys, ureter, or urethra.  During this, the ureters are removed from the bladder. The urine flow remains there and then goes to a urostomy bag that’ll affix to the abdomen and it’ll either involve leaving the bladder there or taking it out.

This is the least common of the three kinds of the stoma, and it’s formed to get the urine out of the body. This is usually done by the ileum is isolated, and then oversewn, and the ureters are put there.  Immediately after surgery is done, there are stints in others to help prevent any anastomosis between the bowel and ureter from stenosing. 

This is usually a permanent end stoma.  The appliance to use this is, of course, a drainable bag with a bung or tap.  The part of the bowel that’s used to form the urostomy will help contain small amounts of mucus along with urine. This is emptied about 4-6 times a day and usually can hold 400 ml of liquid.  This is replaced on alternate days but might vary in some cases.  This usually involves a stoma where the appliance is worn.  The ostomy patient does need to see it and be able to access it, and usually, the ileal conduit goes beneath the waist, and of course to the right of the belly button. The colon conduit goes on the opposite end of this.

There are different types of urostomies too, and there are three which make up the  main practices.

The first is the ileal conduit, which is the resection of a small portion of your ileum, which is the small intestine, and the blood supply that correlates. Surgeons will attach one end to the resected ileum and the abdominal wall in order to create a stoma and then connect the ureters. This will disable the passage between the bladder and ureters, and will flow from the kidneys to the stoma, and then the bag.  Then, the remaining part of the small intestine is connected to improve the digestive function.

There is also the colon conduit, which is similar to the ileal version, but it connects to the colon segment. The stoma is bigger than when you’re using the small intestine, so you’ll need a bag with a much larger diameter. The mechanic are the same though.

Finally, you have the ureterostomy, which is where the surgeon connects the ureters to the abdominal wall, creating a couple of stomas. This is usually linked internally, but sometimes it can be done externally, and if the bladder no longer functions, you’ll then avoid using the large or small intestine with this one.  This usually requires two stomas and two bags, which definitely is much more involved than anything else.

This from there, will cause the urine to flow continuously, and this can be hard to place, especially when compared to fecal versions of this.  You do need to empty it a few times daily, and it should be recommended at night to attach to a drainage system.

And there you have it, a urostomy. It’s a pretty in-depth procedure but can help people if they do have bladder cancer, or urinary issues.