What you need to know about Ureterostomy surgery

Imagine a situation where you are unable to urinate properly due to a problem with your bladder, perhaps due to cancer, an accident, or a congenital condition. In such a case, you need another way to remove urine from your body. Or your kidneys may be damaged . One solution that doctors suggest in such cases is a surgery called a ureterostomy . Although the name of this may sound a bit complicated, let's talk about it simply.

What is Ureterostomy?

Simply put, this is a surgical procedure that involves removing the tubes that carry urine from your kidneys to your bladder (called ureters) and connecting them to a small opening in the skin of your abdomen. This opening is medically called a stoma .

Imagine, when one part of a water pipe system is blocked, we put in a new pipe to bypass the blockage and take out the water. After this surgery, your urine does not go to the bladder but comes out of the body directly from the kidneys through that stoma. To collect the urine that comes out, a special bag (pouch) attached to the stoma is used. When this bag is full, we can empty it.

This surgery is usually done as a permanent solution. Sometimes only one ureter can be connected, or both can be connected.

Why do you need to have this kind of surgery?

There are several reasons why a doctor might suggest this surgery for you. The main reason is that your bladder is not functioning properly.

• In the event of a bladder removal: Sometimes, due to a medical condition such as bladder cancer, it may need to be completely removed.
• When the bladder is damaged: When the bladder is damaged due to an accident or other medical condition and does not function properly.
• Congenital Anomalies: Some congenital conditions, such as spina bifida, can cause bladder dysfunction.
• Spinal Cord Injury: Spinal cord injury can affect the nerves that control the bladder, causing difficulty urinating.

What tests are done before surgery?

Before performing this surgery, the doctors will perform several tests to get a better understanding of your body's condition.

Also, before the surgery, a doctor or a specially trained nurse will talk with you to determine the best place to create the stoma. It should be somewhere that you can easily see and won't get caught in your clothing (e.g., a belt) .

Life after surgery and caring for the stoma

After surgery, you'll have to adjust to a new way of life, but it's not as difficult as you might think.

How the stoma and bag work

The stoma is not a muscle. Therefore, it cannot control urine . Urine continues to come out in a trickle.

• Pouching System: This has two parts. One is the barrier that sticks to the skin. The other is the pouch that collects urine. Sometimes, units come with both.
• Barrier: This is a square sticker with a hole in the middle to fit the stoma. The special gum on this helps prevent urine from leaking out and keeps it firmly attached to the skin.
• Urine pouch: This is attached to the skin patch. Urine collects directly into this.

Usually, the bag should be emptied when it is one-third or one-half full . Without removing the bag, you can open a valve at the bottom and empty the urine into the toilet. At night, you can attach a tube to this valve and have the urine collect in a larger bag. Since these bags fit snugly against the body, they are not visible when you wear normal clothes.

Caring for the stoma and surrounding skin

It is very important to keep the stoma and the skin around it clean and dry.

• Wash the stoma and surrounding skin every day using a mild soap and water.
• Rinse with water until the soap is gone.
• Then, let it dry thoroughly. It's not good to have moisture.

The pouch and barrier need to be changed every 5-7 days . The hospital will teach you how to do all of this.

When do you need to talk to the doctor?

Always pay attention to your stoma and the skin around it. If you notice any changes, let your doctor know right away.