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Urostomy - stoma and skin care

Ostomy care - urostomy; Urinary diversion - urostomy stoma; Cystectomy - urostomy stoma; Ileal conduit

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Description

Urostomy pouches are special bags that are used to collect urine after some types of bladder surgery.

Instead of going to your bladder, urine will go outside of your abdomen. The part that sticks outside your abdomen is called the stoma.

After a urostomy, your urine will go through your stoma into a special bag called a urostomy pouch.

Caring for your stoma and the skin around it is very important to prevent infection of your skin and kidneys.

About Your Stoma

Your stoma is made from the part of your small intestine called the ileum. Your ureters are attached to the end of a small piece of your ileum. The other end becomes the stoma and is pulled through the skin of your abdomen.

A stoma is very delicate. A healthy stoma is pinkish-red and moist. Your stoma should stick out slightly from your skin. It is normal to see a little mucus. Spots of blood or a small amount of bleeding from your stoma is also normal.

You should never stick anything into your stoma, unless your health care provider tells you to.

Your stoma has no nerve endings, so you will not be able to feel when something touches it. You also will not feel if it is cut or scraped. But you will see a yellow or white line on the stoma if it is scraped.

Caring for the Skin Around Your Stoma

After surgery, the skin around your stoma should look like it did before surgery. The best way to protect your skin is by:

• Using a urostomy bag or pouch with the correct size opening, so urine does not leak
• Taking good care of the skin around your stoma

To care for you skin in this area:

• Wash your skin with warm water and dry it well before you attach the pouch.
• Avoid skin care products that contain alcohol. These can make your skin too dry.
• Do not use products on the skin around your stoma that contain oil. These can make it hard to attach the pouch to your skin.
• Use special skin care products. This will make problems with your skin less likely.

Be sure to treat any skin redness or skin changes right away, when the problem is minor. Do not allow the problem area to become larger or more irritated before asking your provider about it.

The skin around your stoma can become sensitive to the supplies you use, such as the skin barrier, tape, adhesive, or the pouch itself. This could happen slowly over time and not occur for weeks, months, or even years after using a product.

If you have hair on your skin around your stoma, removing it may help the pouch to more securely stay in place.

• Use trimming scissors, an electric shaver, or have laser treatment to remove the hair.
• Do not use a straight edge or safety razor.
• Be careful to protect your stoma if you remove hair around it.

When to Call the Doctor

Call your provider if you notice any of these changes in your stoma or the skin around it.

If your stoma:

• Is purple, gray, or black
• Has a bad odor
• Is dry
• Pulls away from the skin
• Opening gets big enough for your intestines to come through it
• Is at skin level or deeper
• Pushes farther out from the skin and gets longer
• Skin opening becomes narrower

If the skin around your stoma:

• Pulls back
• Is red
• Hurts
• Burns
• Swells
• Bleeds
• Is draining fluid
• Itches
• Has white, gray, brown, or dark red bumps on it
• Has bumps around a hair follicle that are filled with pus
• Has sores with uneven edges

Also call if you:

• Have less urine output than usual
• Fever
• Pain
• Have any questions or concerns about your stoma or skin

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.

DeCastro GJ, McKiernan JM, Benson MC. Cutaneous continent urinary diversion. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 140.

Lyon CC. Stoma care. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell DF, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 232.

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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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