Do you want to know about urostomy surgery? Let's talk about it!

You may have been scared by the word 'Urostomy'. Or maybe when the doctor talks about this type of surgery, one question after another comes to mind. Actually, this is nothing to be afraid of. This is a procedure that creates an alternative way for someone who has some obstruction in the body's normal urinary system to pass urine. Simply put, this is a way to help our body. So, today we will talk about this very simply, in a way that you can understand.

What is a Urostomy in simple terms?

A urostomy is a surgical procedure that creates a small opening in your abdomen, or stomach, for urine to pass through. This opening is medically called a 'stoma' . This means that the urine that is produced in your body, instead of going out normally, comes out through this new opening. This is called 'urinary diversion' .

To collect the urine that comes out like this, we use a special bag (urostomy bag) that is attached to the stoma. We can then easily remove the urine that collects in that bag.

In what cases is this surgery necessary?

There are several reasons why a urostomy may be performed. Let's look at them in the table below.

Whatever the reason, urostomy surgery creates a new, safe path for urine to exit the body.

Are there types of urostomy surgery?

Yes, there are several methods of performing this surgery. They are named according to the way in which the new path for urine is created.

Ileal Conduit - The most commonly used method

This is the most common procedure. Here, the surgeon takes a small piece of your small intestine and makes a tube out of it. One end of this tube is connected to a stoma that has been created in your abdomen. The other end is connected to the two tubes that carry urine from your kidneys (ureters). The urine produced in your kidneys then flows through this new tube and out the stoma.

Colonic Conduit

This is very similar to the method mentioned above, except that a portion of the large intestine (colon) is used to create the tube instead of the small intestine.

Ureterostomy

In this method, a tube is not made from a piece of intestine like that. Instead, the ureters from the kidneys are connected directly to a stoma created in the abdomen.

How do you prepare before surgery?

Before the surgery, your surgeon and team will talk to you carefully. They will explain the following to you:

• Why do you need this surgery?
• What happens during the surgery?
• What to expect after surgery?
• What are the risks associated with this?

They will also advise you on when to stop eating and drinking before surgery, and whether or not you should stop taking any medications you normally take. Be sure to tell your doctor about all medications, vitamins, and supplements you are taking.

Before surgery, your medical team will help you choose the best place on your abdomen to create the stoma. It should be a flat area that you can easily see, reach, and reach.

What happens during the surgery?

You will be put under general anesthesia for the surgery. So you will not feel any pain . The surgeon will create a stoma in a pre-selected location in your abdomen and connect the ureters to it.

Sometimes, especially in cases of cancer, the entire or part of the bladder may need to be removed at the same time. Also, if necessary, organs such as the appendix, lymph nodes, or the prostate gland in men or the uterus in women may need to be removed. This surgery can take up to 6 hours .

How is the recovery time after surgery?

After surgery, you will first be taken to a recovery unit and then transferred to a ward.

• One or more drains will be placed to remove fluid that accumulates in the body.
• The necessary pain medication will be provided.
• You will be encouraged to sit up in bed as soon as possible, move your legs, and walk with the help of medical staff. This can help prevent conditions like blood clots and pneumonia .
• You can start eating and drinking normally in a few days.

You will usually have to stay in the hospital for between 3 and 7 days. During this time, you will be taught how to care for your stoma and how to use your urine bag. After you return home, it may take about two months to return to normal activities (work, school).

What time should I call the doctor?

If you have any questions or concerns about your urostomy, talk to your doctor. Be sure to seek medical advice, especially if you have any of these symptoms:

• Fever
• Abnormal bleeding
• Severe pain
• Difficulty using the urostomy bag
• Change in urine color or strong odor

Common questions about living with a urostomy

You probably have a lot of questions about life after this surgery. Let's answer them.

What does a stoma look like? How does it feel?

When you first look at your stoma, it may be slightly swollen, dark red, and look bruised. This is normal. Over time, the swelling will go down, turn a light pink color, and shrink in size. It may be round or oval in shape.

Most importantly, the stoma does not have nerve endings. Therefore, the stoma does not feel anything or hurt . Although the surrounding area may feel pain until the surgical wound heals, the stoma itself does not feel pain.

How often should the urostomy bag be changed?

Emptying the bag and changing it completely are two different things.

• Emptying the bag: Just like you would urinate before surgery, you should empty the bag every few hours. Do not wait until the bag is completely full. It is best to empty it when it is one-third (1/3) or one-half (1/2) full. This will help prevent the bag from leaking and causing skin infections. When you sleep at night, you can connect this bag to a larger reservoir (drainage container). This will allow you to sleep without getting up at night.
• Changing the bag: This depends on the type of pouching system you are using. Some need to be changed daily, while others can be used for 3 days or even a week.

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