Can You Get Urinary Tract Infections (UTI) With a Urostomy?

If you’ve had a urostomy, you already know it comes with many changes to how your body functions and how you care for it daily. One common question that people often ask is whether urinary tract infections (UTIs) are still a concern after surgery. The short answer is yes: even without a bladder, it's still possible to develop a UTI. Here, we'll go into more detail regarding why this happens and what ostomy care tips you can adopt to help prevent it.

What Is a Urostomy?

A urostomy is a type of ostomy procedure that creates a new way for urine to leave the body when the bladder is no longer able to do so. This can be due to several underlying reasons, with the most common being bladder cancer.

Regardless of the reason, the surgery is generally the same (with a few variations). A surgeon will redirect urine flow by using a small section of the intestines to form a conduit, which connects the ureters (tubes that carry urine from the kidneys) to an opening, or stoma, created on the surface of the abdomen.

This allows urine to drain continuously into an external urostomy pouch worn outside the body. Unlike other forms of urinary diversion, a urostomy is typically permanent and requires ongoing care to manage the stoma and prevent complications. There are some instances where it can be reversible, or an internal pouch can be utilized with catheterization, but these options may not be suitable for everyone.

What Is a Urinary Tract Infection?

A urinary tract infection (UTI) is an infection that occurs anywhere along the urinary system, which includes the kidneys, ureters, bladder, and urethra. Most times, UTIs affect the lower urinary tract, specifically the bladder and urethra. However, bacteria can travel upward via the ureters and affect the kidneys, which may lead to more serious complications. UTIs are common, but prompt treatment is required to reduce the risk of long-term damage.

Some of the most common symptoms of a UTI include:

• A strong, persistent urge to urinate
• A burning sensation or pain during urination
• Passing frequent, small amounts of urine
• Cloudy or foul-smelling urine
• Urine that appears red, pink, or brown (a possible sign of blood)
• Pelvic pain, especially in women (often centered around the pubic bone
• Feeling tired or shaky)
• Low-grade fever or chills (may indicate the infection is spreading to the kidneys)
• Pressure or discomfort in the lower abdomen

If the infection reaches the kidneys, symptoms can also include a high fever, pain in the side or back, nausea, and vomiting. When left untreated, this can result in even more serious complications, so it's important to see your doctor as soon as possible.

The primary difference between a UTI before and after a urostomy is that you may not feel the same burning sensation or pain as urine enters the ostomy pouch.

Can You Get a UTI With a Urostomy?

Yes, you can still get a urinary tract infection with a urostomy. The surgery doesn't remove the urinary tract entirely; it simply redirects it. In fact, the changes following a urostomy surgery may actually make you more susceptible to UTIs. This is primarily the increased risk of bacteria entering the urinary tract when you change your ostomy pouch or during periods of peristomal skin irritation.

How to Treat a UTI

After a urine sample is taken from a urostomy and the presence of bacteria has been confirmed, treating a UTI is pretty simple. Your doctor will prescribe you an antibiotic based on the type of bacteria present and will recommend painkillers if you're experiencing any discomfort. During this time, it's recommended to drink plenty of water and get enough rest. If you notice that your symptoms aren't improving after 48 hours, contact your doctor to determine your next steps.

Tips for Preventing Urinary Tract Infections With a Urostomy

Although some people may find that they're more susceptible to urinary tract infections after urostomy surgery, that doesn't mean you need to continue dealing with them. There are a few proactive measures you can take to help prevent UTIs and keep your urinary system functioning its best. Here are a few tips to get you started:

1. Prioritize Hygiene and Handwashing

One of the simplest and most effective ways to prevent infection is proper hand hygiene. Always wash your hands with soap and warm water before and after handling your stoma, pouch, or any urostomy supplies. Even if you're emptying your urostomy pouch in your own bathroom, you need to wash your hands. If you don't, the risk of urinary tract infections increases dramatically.

2. Keep Your Urostomy Supplies Clean and Properly Maintained

If you use any reusable components, be sure to clean and disinfect them daily. For example, if you're using a night drainage bag, you should rinse it thoroughly with warm soapy water, then soak it in a vinegar and water solution or a manufacturer-approved disinfectant to kill any lingering bacteria. Allow them to air dry completely before reuse. If you're not sure if your products are reusable or not, ask your stoma care nurse.

3. Empty Your Pouch Frequently

To keep UTIs at bay, try to empty your pouch when it's about one-third to one-half full. A full pouch creates back pressure, which can cause urine to flow backward toward the kidneys, something that increases your risk of infection. Overflowing can also lead to leakage around the stoma, further compromising the skin and opening the door to bacteria.

4. Stay Well Hydrated

You're at a higher risk of becoming dehydrated following urostomy surgery, so it's important to be proactive about your liquid intake. Drinking plenty of fluids helps flush bacteria out of the kidneys and urinary tract, reducing the chance of infection. Aim to drink at least eight to ten glasses of water each day unless your doctor advises otherwise. You can also check your hydration based on the color of your urine: clear or pale-yellow is usually a good sign. If your urine is dark, concentrated, or has a strong odor, increase fluids and see your doctor if you experience any signs of dehydration.

Although some people believe that drinking cranberry juice is the best way to help prevent UTIs, its effectiveness is still unsure. Plus, people with a urostomy may not absorb the proanthocyanidins (PACs) as readily, making it less effective. Before taking cranberry supplements, talk to your doctor; especially if you're taking Warfarin or another blood thinner.

5. Monitor Your Urine for Changes

Living with a urostomy means you’ll get pretty familiar with what your urine normally looks and smells like. Be on the lookout for changes such as foul odor, unusual cloudiness, or signs of blood, as these can be early indicators of a developing UTI. Mucus in the urine is normal in small amounts, since the conduit is made from intestinal tissue that naturally produces it, but an excessive amount or sudden increase may warrant a conversation with your doctor or stoma nurse.

6. Practice Good Stoma and Peristomal Skin Care

Infections can start when bacteria enter through breaks or irritation in peristomal skin. Make sure to clean the area gently with warm water during each appliance change, and pat it dry before applying a new pouch. And avoid harsh soaps, baby wipes, or alcohol-based products. If you notice redness, swelling, or pain around your stoma, contact your doctor.

7. Avoid Backflow and Reflux

Backflow occurs when urine moves backward from the pouch or drainage tubing toward the kidneys. To reduce this risk, make sure all tubing connections are secure and that drainage bags hang below the level of your stoma. Some night drainage systems come with anti-reflux valves to help prevent this. Otherwise, keep your system lower than your abdomen to reduce your risk and improve gravity-assisted drainage.

8. Use Catheters or Irrigation Devices With Caution

Some people with urostomies may occasionally need to use catheters to clear mucus blockages in the stoma or conduit. Others use catheters to drain internal pouches. If this is part of your routine, it's essential to follow sterile technique. Always use a clean or sterile catheter, wash your hands before and after, and never reuse single-use supplies. If you're unsure how to do this safely, ask your urologist or ostomy nurse for a demonstration or training session.

9. Know When to Seek Medical Help

Even with the best care, UTIs can still happen. The key is catching them early. If you feel unwell or experience fever, chills, back or flank pain, nausea, or noticeable changes in your urine or stoma output, don’t wait. Early treatment can prevent the infection from spreading and reduce the risk of complications.

If you’re living with a urostomy, Byram Healthcare is here to help. As a trusted provider of ostomy supplies and personalized customer care, Byram offers a wide selection of high-quality ostomy products delivered right to your door.