Urostomy

 A urostomy is a surgical procedure that is performed to create an opening in the abdominal wall that enables the body to pass out urine. Urostomy is performe in case of an injured or diseased bladder. The location of the Ostomy is different for each type of urinary diversion. A small portion of the bowel is used to create a reservoir pouch that is used for storing the urine inside the body. It acts as a bladder where the urine is normally stored before leaving the body.

What are some common types of urostomies?

There are three common types of urine diversion:

Ileal or colonic conduit: In this type of diversion a small portion of the small or large bowel (colon or ileum) is used to make a reservoir for storing urine and then it is attached with the stoma. There is a pouch or bag that is placed over the stoma to collect the urine outside the body.

Internal continent pouch or reservoir: This involves the Kock pouch and the Indiana pouch. A small portion of the bowel is used to form an internal reservoir that will store the urine. It is then brought to the stoma. There is a wall near the abdomen that prevents the backflow of the urine or leaking of urine out of the stoma. These types of patients use a catheter to drain the urine.

Neobladder: It is just like an internal continent pouch as it also involves an internal pouch that is used to store the urine. But it is connected with the urethra despite stoma. This process enables almost normal urination. This needs regular physiotherapy to make the muscles habitual and control the urine.  Most of the people can’t attain complete continence, especially at night it is a major issue.

What are some risks after the urostomy?

Patients with any kind of urinary diversion may get some long-term problems and they need to be in a contact with a urologist throughout their life.

Chronic tract infection may be caused due to frequent catheterization incontinent diversion. Kidneys dysfunction and hydronephrosis can be caused due to urine reflux.

If there is a reconstruction that involves the bowel it can cause long-term problems associated with urinating. Some most common problems are:

• B12 vitamin loss

• Kidney stones

• Osteopenia

• Osteoporosis

• Metabolic acidosis

The part of the bowel that was involved produces mucus continuously, which can cause stoma coagulation. It can also lead to a positive pregnancy test in both men and women.

The part of the bowel that was involved in the formation of the reservoir has chances to develop colon polyps or cancer. It has the highest risk of cancer than the normal population. These tumors can develop after the 5 years of the surgery.

There are higher chances to develop chronic bowel diseases as a result of the formation of the ileocecal valve, which is involved in the formation of a continent bladder. Some common issues are:

• Poor digestion of fats

• Decreased vitamin absorption

• Gall and kidney stones

• Loose feces

• Incontinence

How to look after the stoma?

To avoid any skin breakdowns and complications you need to learn how to take care of your stoma properly. Your Ostomy expert or nurse can guide you in this aspect. He or she will help you with how to change the bag and use Ostomy appliances. If you observe any stomal changes such as any redness, swelling then contact your doctor without wasting time.

Life of an Ostomy Patient

An Ostomy can bring a lot of problems such as psychological issues, skin problems, and social limitations. But you need not worry it will take some time but you will be used to live with it. Most people feel lonely and isolated after the surgery. Always remember that there are a lot of people who have gone through Ostomy like you and they are living a complete and happy life. You can talk with them so that you can learn from their experiences.

What are some sexual changes that may occur?

Cystectomy surgery may cause damage to nerves and it can be a reason for the dysfunction of the erectile. Women can lose a small part of the whole vagina during the surgery.

For men:

The men who are suffering from erectile dysfunction may live with it for several years. Early medication can prevent muscle loss (penis) and increase the chances of recovery. In case of erectile dysfunction does not recover, then you can discuss with your doctor the alternate sources which allow you to have normal sex. If you have a bladder surgery there may be no semen production, so they would have an a dry orgasm.

For Women:

In case if your vagina has been removed it is possible to reconstruct it by involving tissues from any part of the body. This will enable a woman to have intercourse. Their orgasm produces no natural lubricant. That Is why a lubricant can be used before intercourse.

How to find support?

• You can get help from an Ostomy nurse

• You can find help at support groups and online groups

• Anyone who has experienced an Ostomy may help you.