A urostomy is an opening on your tummy (abdomen) made during surgery. It lets urine (pee) drain out of the body from the kidneys if your bladder has been removed.
It is sometimes called an ileal conduit urinary diversion because it is made using part of the bowel called the ileum.
There are different types of urinary diversion and different types of stomas. We have more information about the following types:
- Bladder reconstruction (neobladder) – this is an operation to make a new bladder from a section of your bowel.
- Continent urinary diversion – this is an internal pouch connected to an opening on your tummy that you empty using a tube (catheter).
- Nephrostomy – this is an opening on the back of the body that lets urine drain from the kidney.
- Colostomy and illeostomy – this is an opening connecting the bowel to the tummy. These are not often part of treatment for bladder cancer.
The surgeon makes the urostomy during the operation to remove the bladder.
To make a urostomy they:
- remove a section of the small bowel called the ileum
- join one end of this to the 2 tubes called ureters from your kidneys
- bring the other open end of the section of bowel out through a small opening in the skin of the tummy. The opening is called a stoma.
Before the operation, the surgeon or stoma nurse will talk to you about the best position for your stoma.
After the operation, you will not pass urine in the same way as before. Instead, urine flows from your kidneys through the ureters and the piece of bowel and out of your body through the stoma.
You wear a bag over the stoma to collect the urine. The stoma should be easy for you to reach to empty or change the bag.
A urostomy bag is a flat, watertight bag that you wear over the stoma to collect your urine (pee). Sometimes it is called a urostomy pouch.
The bag has a sticky back which can stay in place for several days without needing to be changed. It also has a small tap or valve at the lower end so you can empty the bag into a toilet when needed.
There are different brands and types of urostomy bags. These are available free on prescription. Your stoma nurse can give advice about which types might work best for you.
For the first few days after your operation, your nurse will look after your urostomy for you. They will make sure that the bag is emptied and changed when needed.
The urostomy stoma will be bruised and swollen at first. But it will shrink to its final size within a few weeks. At first, it is not unusual for the stoma to bleed slightly when cleaned. Your nurse will tell you more about this. The stoma will also produce mucus. This is a thick, white liquid. It might appear as pale threads in the urine (pee).
As soon as you feel ready, your nurse will show you how to clean your stoma and change the bag. You may want to have a family member or friend with you while you are taught how to care for your stoma. This means they will know how to help you at home, if needed.
Before you leave the hospital, the nurse will make sure you have a supply of the things you need to clean the stoma and change the bags. When you are at home, you can get your equipment directly from a supplier or your chemist. Your nurse will tell you more about this. The Urostomy Association can also give you details of suppliers.
When you get home, you will still be able to speak to your specialist nurse for advice. The hospital staff will arrange for a district nurse or a community stoma nurse to visit you when you first leave the hospital. They can help you cope with any problems.
A urostomy produces urine (pee) steadily through the day. Most people get into their own routine of when and how often the bag fills up and needs emptied.
To empty your urostomy bag, you will do the following:
- Get into a comfortable position that lets you aim the urostomy bag tap or valve into the toilet. Some people stand or kneel. Others prefer to sit on the toilet.
- Open the tap or valve at the lower end of the urostomy bag and let the urine empty into the toilet.
- Dry the tap with toilet paper and make sure it is closed.
At night, you can attach a larger bag to the tap at the bottom of your urostomy bag. Overnight urostomy drainage bags collect more urine so you do not need to empty them until the morning.
Put empty used urostomy bags in a sealed bag and dispose of them in your household rubbish.
Before you change your bag, make sure that you have everything you need. It is a good idea to keep everything you need in one place. This means you do not have to search for things at the last minute. Give yourself plenty of time, so you can work at your own pace without any interruptions. Wash your hands before and after to help prevent infections.
Your stoma nurse will give you advice about the following:
- How often to change your urostomy bag – some types are made to stay on for several days, but it can vary.
- Urostomy stoma care – when you change the bag it is important to clean the stoma and nearby skin carefully. Your stoma may bleed a little when you clean it. This is normal. But tell your stoma nurse if you have sore areas around the stoma or notice blood coming out of the stoma hole.
- How to fit the new bag – the bag should fit closely around the stoma to keep urine away from your skin and prevent soreness. Tell your stoma nurse if you find the type of urostomy bag you have difficult to use. They can give you advice or may suggest another type of bag.
Having a urostomy is a big change to your body. It can take time to get used to. Your specialist nurse will give you lots of support before and after your operation. They will show you how to care for and manage the stoma.
You may find it helpful to talk to someone who is used to living with a urostomy. Your stoma nurse or the Urostomy Association may be able to arrange this for you. This can be very helpful, especially in the first few months after your operation.
Urostomy bags are flat. This means they will not be easily noticed under your clothes. How noticeable the bag is through your clothes depends on the size of the stoma and where the stoma is on your tummy.
Many people with a urostomy can wear their tightest clothes without anyone knowing they have a stoma bag. You may be very aware of your urostomy. But people will not usually notice it unless you choose to tell them.
If you feel anxious about your body or about going out in public, it may help to talk to others in a similar situation. Our Online Community has a stoma support forum where you can share your experience and find out how other people have coped.
Having a urostomy will not usually affect the activities you can do. Many people are able to do go back to work and can do hobbies, including swimming. If you are worried about your life after surgery, you can talk to your stoma nurse.
Below is a sample of the sources used in our bladder cancer information. If you would like more information about the sources we use, please contact us at email@example.com
Mottet N, Bellmunt J, Briers E, et al. Non-muscle-invasive bladder cancer (TaT1 and CIS). European Association of Urology (Internet), 2021. Available from uroweb.org/guideline/non-muscle-invasive-bladder-cancer (accessed September 2021).
Witjes JA, Bruins HM, Cathomas R, et al. Muscle-invasive and metastatic bladder cancer. European Association of Urology (Internet), 2021, Available from uroweb.org/guideline/bladder-cancer-muscle-invasive-and-metastatic (accessed September 2021).
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Ursula McGovern, Consultant Medical Oncologist.
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