Urostomy: Care at home

What is a Urostomy?

A urostomy is a surgical opening (stoma) into the abdomen allowing urine to flow out of the body after the bladder has been removed. It may also be called a urinary diversion.

Stoma site appearance

• Always red and moist. However, sometimes when your child is crying, you may see some color changes. The color should return back to red or normal color for your child when crying stops.
• The site may bleed easily, especially if hit or rubbed. Bleeding should be minor.
• You may have small tubes called stents placed into the stoma during surgery that will remain in place for a few weeks after surgery. These will drain into your pouch.
• The stoma may stick out above skin level or be slightly below skin level.
• The skin around the stoma should be free of rashes and broken down areas. Use products that fit well to minimize leakage. Empty bags frequently. Each stoma is unique.
• Urine will flow from the urostomy immediately after surgery. At first, it may be a pink color. There may be mucus.
• The stoma should not be painful. There are no nerve endings in the stoma.

Output expectations

Urine will have mucus, may be pink initially. Odor is a major concern for those with stoma surgery. Pouches are made with an odor-barrier film, so odor is contained within the pouch.

Emptying the pouch

• Empty the pouch when it is 1/3 - 1/2 full of urine. If it gets too full, it will leak or not last as long.
• Empty before naptime, bedtime, and car trips.
• Because urine will drain continuously, emptying will depend on intake and the size of the drainage bag.
• You may need to use a night time drainage system.

When should I change the pouch?

The wear time of a pouch typically ranges from 1-2 days for an infant and up to 3 days for child, depending on output, activity, and other factors.

Change the pouch when:

• The pouch is loose or it starts to leak.
• Your child tells you his or her skin burns or itches.
• Your child is fussy for no apparent reason.

For detailed steps on changing the pouch, refer to the education handout "Pouch change."

Skin care

To clean the skin around the stoma, just use water on a soft paper towel. Do not use baby wipes, oils, powders, ointments, or lotions on the skin around the stoma.

Activity guidelines

Bathing: Check with your urologist before allowing water to cover the stoma. The stoma may produce output while bathing. Avoid oily soaps and lotions around the stoma. Dry the skin around the stoma after bathing and check the seal for integrity.

Swimming: Use the pouch while swimming. An ostomy belt or waterproof tape around edge of skin barrier can assist security of system. Remove tape as soon as done as this can irritate skin.

Sleeping: Empty before naps and before bedtime. Older children can sleep on their abdomen; this will not hurt the stoma. Infants should sleep on their backs for safety.

Travel: Pack all supplies as carry-on. Avoid placing the seat belt over the stoma. Carry wet paper towels for clean up, not wipes.

Clothing: Avoid clothing that has waistbands that might rub against the stoma or that are so snug they prevent the pouch from filling. For babies, onesies work well.

Who should I call for help?

Call your clinic if:

• The area around the stoma becomes red, broken down, open, and moist. This can interfere with a good pouch seal.
• You are changing the bag more than once/day or more often consistently, you increase the chance of skin breakdown.
• The stoma sticks out further than it had.
• The stoma sinks below skin level.
• Bleeding: The stoma may bleed, and this is normal. If the bleeding does not stop, contact your health care provider immediately.

Special Tips

• Change the pouch when the stoma is less active. Recommended time is first thing in the morning.
• Pick a time when your child is calm and quiet. Have supplies ready to use such as pre-cutting the pouch opening, etc.
• Until you can do it yourself, plan on having extra hands available for pouch changes.

Questions?

This is not specific to your child, but provides general information. If you have any questions, please call your doctor.

Reviewed by WOCN 8/2015 

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