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Changing your urostomy pouch

Urinary pouch; Urinary appliance pasting; Urinary diversion - urostomy pouch; Cystectomy - urostomy pouch

Urostomy pouches are special bags that are used to collect urine after some types of bladder surgery. The pouch attaches to the skin around your stoma, the hole that urine drains from. Another name for a pouch or bag is an appliance.

You will need to change your urostomy pouch often.

When to Change the Pouch

Most urostomy pouches need to be changed 1 to 2 times a week. It is important to follow a schedule for changing your pouch. Do not wait until it leaks because urine leaks can harm your skin.

You may need to change your pouch more often:

  • During the summer
  • If you live in a warm, humid area
  • If you have scars or oily skin around your stoma
  • If you play sports or are very active

Always change your pouch if there are signs that it is leaking. Signs include:

  • Itching
  • Burning
  • Changes in the appearance of the stoma or the skin around it

Changing Your Pouch

Always have a clean pouch on hand. You should always carry an extra one with you when you leave your house. Using a clean pouch will help prevent infections in your urinary system.

You can decide whether it is easier to sit, stand, or lie down when you change your pouch. Choose a position that allows you to see your stoma well.

Urine may dribble from your open stoma when you change the pouch. You can stand over a toilet or use rolled up gauze or paper towels below your stoma to absorb the urine.

When you remove the old pouch, push down on your skin to loosen it. Do not pull the pouch off your skin. Before you put the new pouch in place:

When you put the new pouch in place:

  • Carefully place the opening of the pouch over your stoma. Having a mirror in front of you may help you center the pouch correctly.
  • The pouch opening should be 1/8th of an inch (3 mm) larger than your stoma.
  • Some pouches are comprised of 2 parts: the wafer or flange, which is a plastic ring that adheres to the skin around the stoma, and a separate pouch that attaches to the flange. With a 2-piece system, the separate parts can be changed at different intervals.

References

American Cancer Society website. Urostomy guide. www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/ostomies/urostomy.html. Updated October 16, 2019. Accessed August 23, 2022.

Erwin-Toth P, Hocevar BJ. Stoma and wound considerations: nursing management. In: Fazio VW, Church JM, Delaney CP, Kiran RP, eds. Current Therapy in Colon and Rectal Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 91.

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Review Date: 4/10/2022

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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