What is a urostomy?
A urostomy is a stoma formed to divert the normal flow of urine from the kidneys and ureters. To create the stoma, the surgeon will isolate a short piece of small bowel from which a tube or spout (known as an ileal conduit) will be fashioned. The two ureters will be plumbed into this spout which will be brought to the surface of the abdomen and sutured to the skin. Urine will pass through the stoma, completely bypassing the bladder. The bladder may or may not be removed, however a urostomy is permanent.
Why might somebody need a urostomy?
There are a number of reasons for a urostomy due to disease or damage to the bladder or urinary system. Babies are sometimes born with a defect of their urinary system. In adults, neurological disorders leading to severe incontinence or bladder cancer may result in urostomy surgery.
How the urinary system normally works
The urinary system comprises:-
- Two kidneys – filter blood and remove waste products and excess water
- Two ureters – tubes which connect the kidney to the bladder
- One bladder – reservoir for urine
- One urethra – tube connected to bladder which expels urine.
- Urine is produced in the kidneys (approximately 2 litres per day). It is then carried down long tubes called ureters to the bladder where it is stored. Urine flows continually into the bladder from the ureters and during the course of a normal day the bladder will gradually fill. Once it is approximately half full the first sensation of wanting to pass urine occurs and the bladder will contract and squeeze out the urine via the urethra. In healthy adults this process of urination is under voluntary control.
Waste from a urostomy
The flow of urine from a urostomy is continuous and a urostomy bag with a tap will be worn which will need emptying several times per day. The urine may contain some mucus as it has been formed from small bowel which is a mucous membrane. The urostomy bag may be attached to a night drainage bag at night time and the bag will be changed every few days according to personal preference.