A urinary tract consists of two kidneys, two ureters, one bladder, and a urethra. Kidneys filter out urine from blood and transport it to the bladder through ureters. When the bladder is full, we feel the urge to urinate. The urine then passes through the urethra.
A urostomy refers to a diversion in the urinary tract. The urine passes out through an opening (stoma) on the abdomen, bypassing the bladder and the rest of the urinary tract.
The stoma formation
The surgeon cuts a small piece of the ileum to use it as a conduit. The bowel is then reconnected to allow it to work as usual. The ureters are disconnected from the bladder and connected to the conduit. The other side of the conduit is passed through a small cut in the abdominal wall to create a stoma. The kidneys produce urine, which flows through ureters and enters the conduit. The conduit transports urine to the stoma from where it passes out.
Why is a urostomy necessary?
You may need a urostomy for a variety of reasons. All of these reasons result in defects in the urinary system. That makes the urinary diversion necessary.
In some cases, the surgeon may opt to remove your bladder. Most of these cases involve cancer in the bladder. In some cases, there may be a birth defect in the bladder. Spina Bifida is one of the most typical examples of a defect in the bladder or urethra.
Some conditions result in bladder dysfunction. Those include Cerebral Palsy, Multiple Sclerosis, spinal injury, and nerve damage.
Some gynecological problems can lead to continence problems. These problems mainly include a urinary fistula and other problems with the bladder that affect its muscles and sphincters. Other reasons for a urostomy include painful bladder syndrome and interstitial cystitis.
Sometimes, a defective bladder may not be as problematic as in other cases. In such a scenario, it is up to the patient to decide whether or not to get a urostomy. Patients facing such conditions usually opt for a urostomy for social reasons. Their inability to control the flow of urine causes embarrassment for them. So, they consider a urostomy a more manageable alternative compared to continuing living with a defective bladder.
Interestingly, most people with urostomies discover how improved the quality of life can be with a urostomy. They can do so because they get rid of the root cause of the issue. Some people even consider urostomy surgery a moment that gave them a new life.
A stoma is a bud-like structure sticking out on the abdomen. It is usually moist, red, and much like the inside of the mouth due to the presence of a mucous membrane on its outer surface. It may secrete some mucus with urine, but that shouldn’t be a cause of concern. This mucus secretion subsides over time.
Because a stoma doesn’t have any nerve ending, you will not feel any pain or sensation on it. However, it may bleed easily due to the presence of too many blood vessels.
To manage your urostomy and stoma, you have to use a urostomy pouch, which is a plastic pouch that prevents urine from leaking or falling out. This pouch fits over the skin around the stoma, allowing the stoma to open into the inside of the bag.
You will learn a lot about how to manage your urostomy from your ostomy care nurse. Over time, you will learn further about how to use an ostomy pouch to manage your stoma.