Individuals undergoing urostomy surgery have to adopt a different lifestyle and routine. This surgery has a lifetime impact and requires the patient to take care of several factors to keep the body healthy and active.
Initially, a patient might not know everything about urostomy care as it needs some time and practice. If the patient is elderly, a caretaker must understand how to care for her loved one with a urostomy. Having useful information and knowledge about urostomy care helps the patient to recover quicker and lead a normal life.
About Urostomy and Stoma
Urostomy is a surgical procedure that involves creating an opening in the belly that permits urine to flow out of the body. It is performed to remove a damaged or diseased bladder. A bladder that is formed after surgery is known as a stoma. A stoma is a part of the small intestine called the ileum that protrudes out of the body. The ureters are attached to the end of the ileum while the other end pulls out of the belly, making a stoma. It is delicate, pinkish, or red that needs appropriate care.
A stoma has no nerve endings, which means a patient won't be able to feel anything in case of a cut or scrap. Certain signs allow the caretaker to know if there is any damage to the stoma.
How to Change the Pouch
After discharge, a nurse guides the patient and caregiver in changing the urostomy pouch and other parts of the pouching system.
Emptying of the Urostomy Drainage Bag
A pouch has a drainage valve for emptying the bag. Since bacteria grow quickly in urine, it is important to empty it instantly after it's 1/2 or 1/3 full. A heavy pouch with lots of urine can also damage the pouch seal, which is why it is crucial to empty the bag regularly. The time of opening the pouch depends upon various factors, such as fluid intake leading to more urine production. A caretaker also needs to empty the urostomy pouch of the children as it's smaller in size.
Following are the steps to empty the drainage bag:Sit on the toilet.
- Put a piece of the tissue in the toilet to avoid splashing.
- Hold the pouch bottom-up and open the valve to drain urine.
- After complete emptying, close the valve and dry its end with toilet paper.
Changing the Urostomy Pouch
Different types of pouching systems require different lengths of time to change. Some pouches need to change daily, some after every three days, and some just once a week. Before changing the pouch, clean the hands and keep all the supplies in front on a clean surface. To avoid even the tiniest mess, it is good to use toilet paper or rolled tissue to absorb the dribbling urine from the stoma.
Ways to Protect Skin Around Stoma
The skin around the stoma should be the same as other skin on the body, but the stoma also makes it a little sore and tender. After handling the ostomy for some time, the caretaker learns to handle it easily. Here are a few useful tips on how to care for your loved ones with a urostomy.
1. Regular Change of Pouching System
Regular urostomy pouch change is recommended as change after too long can cause leakage or skin irritation. It is imperative to have a routine of pouch change rather than waiting for the pouch to become full or start leaking.
2. Right Size Pouching System
A pouch opening that is too small can cut or damage the stoma. On the other hand, a pouching system bigger than the stoma can cause urine leakage or skin irritation. So choose the system that perfectly fits the stoma.
3. Keep the Skin Clean
Cleanliness is crucial to avoid any stoma-related issues. Use water to clean the stoma in a tub or a shower. Pat dry the stoma and skin around it before applying the skin barrier for the urostomy pouch.
4. Remove the Pouching System Carefully
Remove the sticky skin barrier from the skin care by pushing the skin away rather than pushing the barrier out from the skin. Do it gently to avoid any damage. Changing the drainage bag once a day or more is recommended if needed.
5. Allergies and Sensitivities
Skin barrier, pouch material, tape, or paste can cause allergies if the patient is sensitive to any item present in it. It can take days, months, or even years to develop the allergy as the patient become sensitized over time.
Taking Care of Diet
Though there are no species eating restrictions after urostomy surgery, if the patient's kidneys are damaged, the doctor might watch the salt and protein intake. The pH balance of the urine may also be changed, which will be checked by the doctor.
- The pH of the urine should be acidic. For this reason, the patient should drink cranberry juice instead of orange or the juice of any other citrus fruit as this will make the urine alkaline.
- The intake of vitamin C should be in daily routine.
- The alkaline crystals are formed on the stoma or skin caused by alkaline urine. These are gritty white particles that cause skin irritation or even bleeding. A proper diet that makes the urine acidic, regular cleaning, and a perfect-fit pouch will help form urine crystals.
When to Consult the Doctor?
If the caretaker observes the following symptoms, it is necessary to consult the doctor. Neglecting these symptoms for a long can cause permanent damage to the stoma. For this reason, it is crucial to keep an eye on these signs.
- A red or swollen stoma or if rash is present.
- If there is blood in the urine or the urine has a strong odor.
- If feeling pain, nausea, bloating, or vomiting.
- Little or no urine coming out of the stoma.
- A patient has a fever.
- The patient is unable to perform daily activities or tasks.
- When the appearance and size of the stoma changed.