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Urostomy - stoma and skin care

Alternate Names

Ostomy care - urostomy

Description

Urostomy pouches are special bags that are used to collect urine after 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 ureter is attached to a small piece of your ileum and pulled through the skin of your abdomen.

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

You should never stick anything into your stoma, unless your doctor 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

Skin care tips:

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

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

The skin around your stoma can become sensitive to the supplies you use -- 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 stick.

  • Use a trimming scissors, 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 Your Doctor or Nurse

Call your doctor or nurse 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

Maidl L, Ohland J. Care of Stomas. Fischer JE, ed. Mastery of Surgery. 58th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2007:chap 132.

Carpenito-Moyet LJ. Urostomy. Nursing Care Plans & Documentation: Nursing Diagnosis and Collaborative Problems. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2004.


Review Date: 4/12/2012
Reviewed By: Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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