Urostomy

A urostomy is a surgical procedure that creates an opening, or stoma, on the abdomen to drain urine when the bladder is removed or no longer usable. Urine is redirected to an external collection bag attached to the skin around the stoma. The term can refer to the construction of a urinary diversion, in contrast to preserving the native bladder.

The most common form is an ileal conduit, in which a short segment of ileum is used to connect the ureters to the stoma. The other end of the ileal segment is brought to the abdominal surface as a stoma. Other forms include continent urinary reservoirs, which store urine in a surgically created pouch and require periodic catheterization, and ureterostomies, where one or both ureters drain directly to the skin without a reservoir.

Indications for a urostomy include bladder cancer requiring cystectomy, nonfunctional or severely damaged bladder from trauma, neurogenic bladder, severe radiation damage, or congenital bladder abnormalities. The choice of type depends on medical needs, anatomy, and patient preference.

Postoperative care focuses on stoma management, skin protection, and appliance fitting. Patients typically wear a peristomal skin barrier and an ostomy bag to collect urine. Mucus production from the intestinal segment is common and can affect bag performance. Education on bag changes, hygiene, hydration, and odor control is important. Follow-up with a stomal therapy nurse is standard.

Potential complications include stoma stenosis or retraction, parastomal hernia, skin irritation, urinary tract infections, and metabolic changes related to intestinal segments. With proper care and support, many people adapt well and maintain a good quality of life.