What Is a Urostomy?

Whether you're preparing for surgery or supporting a loved one, understanding what a urostomy is can help ease anxiety and promote confidence. Here, we'll go over some essential details explaining what a urostomy is and what to expect after surgery.

What Is a Urostomy?

A urostomy is a surgical procedure that creates a new way for urine to exit the body when the bladder is no longer able to do so. It results in an ostomy, specifically a urostomy, which is an artificial opening in the abdominal wall (stoma) that allows urine to be expelled into a pouching system. In most cases, it’s a life-saving, albeit permanent, surgery. Some, however, are only done temporarily to allow for a particular part of the body to heal or to manage an underlying condition. Regardless, proper ostomy care is essential.

Why Would Someone Need a Urostomy?

A urostomy is required when the bladder can no longer safely or effectively store and release urine. This can happen due to a variety of medical conditions or injuries. Some of the most common include: 

• Bladder cancer (often after a cystectomy, a surgery to remove the bladder completely)
• Neurogenic bladder (i.e., from multiple sclerosis)
• Long-term interstitial cystitis
• Damage from radiation therapy
• Traumatic injuries
• Severe cases of urinary incontinence
• Urinary tract abnormalities
• Spinal cord injuries or congenital disabilities like spina bifida

Different Types of Urostomies

Each type of urostomy is a surgery that creates an opening in your abdominal wall, and almost all will require that you use a pouch attached to the stoma to collect the urine. However, there are a few different types of diversion surgeries, and the kind you receive will depend on the underlying cause and location of damage.

Ileal Conduit

The most common type of urostomy is called an ileal conduit urinary diversion. During the procedure, your surgeon will remove a small piece of your small intestine, typically the end (the ileum). The small intestine is then reattached so that digestion can continue normally. Next, the ureters are detached from the bladder and connected to the ileum so that it can be redirected. After determining the best location for your stoma, the surgeon will bring the ileal segment through the abdominal wall, which allows urine to exit the body without requiring help from the bladder. 

Colonic Conduit

This is a surgery that's similar to an ileal conduit, the only difference being which tissue is used. In a colonic conduit, the surgeon will use tissue from the sigmoid colon to attach the ureters to the stoma.

Ureterostomy

In this surgery, there's no segment of intestine that's used. Instead, the surgeon directly connects one or both of the ureters to the stoma. 

Continent Diversions

The above types of surgeries are considered incontinent urostomies, meaning that you don't have any control over when the urine flows from the stoma into the bag. In continent diversions, internal pouch systems are used and then drained via a catheter throughout the day. There are a few different types that can be used, a few of which include:

• Indiana Pouch: An internal pouch is created from the large intestine, which is connected to the stoma using a catheterizable channel. Individuals use intermittent catheterization to drain the pouch.
• Kock Pouch: This is similar to an Indian pouch, except that the small intestine is used instead.
• Neobladder: This is a procedure that essentially utilizes a new bladder (a reservoir created from the intestine) that's attached directly to the urethra. This allows individuals to urinate without a stoma, but may require physical therapy and is not suitable for everyone.

How to Prepare for Urostomy Surgery

Preparing for a urostomy surgery involves both physical and emotional steps to ensure the smoothest recovery possible. If you're scheduled for a type of urinary diversion surgery, here are a few things to keep in mind.

Before the Surgery

Before the big day, your doctor will likely schedule several preoperative tests and review any of your past treatment plans to assess overall health and surgical readiness. You will also meet with a wound, ostomy, and continence (WOC) nurse to learn more information about the type of surgery you're getting, where it will be on your abdominal wall, and to introduce you to some basic urostomy supplies. This is a great opportunity to ask questions and get a better idea of how your life may change post-op. 

In the days leading up to the surgery, you may be asked to follow a clear liquid diet or do a bowel prep. If these apply, your WOC nurse will give you all the information you need. Certain medications may also need to be stopped for the time being, and it's recommended that smokers quit a few weeks before to help reduce the risk of complications.

Surgical Procedures

The details of how the surgery is performed will depend on the reason for getting a stoma and the type of urostomy you'll need. During the procedure, a surgeon diverts the flow of urine by connecting the ureters (the tubes that carry urine from the kidneys) to a small segment of the intestine. This section of intestine is then brought through an opening in the abdomen called a stoma. During this process, you'll be under general anesthesia, so you'll be asleep and without pain for the entirety of the surgery. This typically takes around four hours.

Post-Op Recovery

Following surgery, you should plan to stay in the hospital for several days to ensure that you're recovering well and don't have any signs of infection around the stoma. You'll also be given training on how to change your urostomy bag and care for your stoma. 

When it's time to go home, your doctor or ostomy nurse will provide you with a detailed post-op recovery plan that underlies everything from what to eat and how to look after your urostomy. A full recovery takes around eight to 12 weeks, but many new ostomates can resume light activities within a few weeks. 

Life With a Urostomy: What to Expect

Adjusting to life with an ostomy can feel overwhelming at first, but with time, education, and support, you will be able to return to your everyday routines. While there are physical changes to get used to, you can still live a full, healthy life. Here are some tips in different areas of your life to consider after recovery.

Caring for Your Stoma

Your stoma won’t have nerve endings, so you shouldn’t feel any pain. Still, it requires gentle daily care to prevent irritation or infection. This includes cleaning the area with warm water, changing your urostomy pouch regularly, and checking the skin around your stoma for any signs of redness or breakdown. Your ostomy nurse will show you exactly how to do this before you leave the hospital. Your stoma may change size during the healing process, which is entirely normal. However, new changes after recovery should be discussed with your stoma nurse.

Changes to Your Diet

Most people with a urostomy can return to a regular diet, but it’s important to stay well hydrated to keep your urine flowing freely and reduce the risk of urinary tract infections. Some foods may cause changes in urine odor or color, and mucus in the urine is also normal. Your care team can help you make any necessary dietary adjustments.

Intimacy With an Ostomy

Having a urostomy may bring up concerns about intimacy, body image, or sexual function. These feelings are entirely normal. Open communication with your partner, finding comfortable pouching options, and speaking with a healthcare provider or counselor can all help. Many people find that intimacy improves once they regain confidence in their body and routine.

Navigating Your Social Life

You may feel self-conscious in the beginning, but most people around you won’t even know you have an ostomy unless you tell them. With today’s discreet pouching systems and clothing options, you can confidently regain your social circle without worry. However, it may be beneficial to join a support group to find other ostomates to connect with.

Work-Related Changes

Whether you have a desk job or a more physically active role, most people can return to work with a stoma after recovery. You may want to start with part-time hours or light duties as you adjust, and keeping an extra set of supplies at work can offer added peace of mind.

Ostomy Clothing to Try

You don’t have to buy a whole new wardrobe after surgery. Many people comfortably wear their regular clothes. However, some prefer high-waisted bottoms, stoma guards, or ostomy wraps for extra support and discretion, especially during exercise or formal events.

Engaging in Sports and Physical Activity

Once you’re fully healed, you can return to most forms of physical activity, including walking, swimming, yoga, and even more intense exercise. Just be sure to protect your stoma from direct impact with a guard or support belt, and talk to your doctor before starting a new fitness routine.

Byram Healthcare is here to support you every step of the way. From expert product guidance to discreet home delivery, we make it easier to manage your urostomy with confidence. Visit Byram Healthcare today to explore high-quality urostomy products, educational resources, and personalized support.