After having a urostomy, you pass urine through an opening (stoma) in your tummy. Learning to take care of your urostomy may seem hard at first, but with time and practice it will become second nature, just like having a bath or shower.
At the hospital
After surgery to remove your bladder, you might have a small hole called a stoma on your tummy (abdomen). Your urine now comes out through the stoma.
You will need to learn how to look after it before you leave the hospital. Your stoma nurse can show you how to do it.
Stoma nurses are experienced in looking after stomas and teaching you how to do this yourself.
You might see your stoma nurse before the operation. They will show you the different types of urostomy bags you can use and they might give you a stoma kit to practice on first.
After your operation, your stoma nurse might change your urostomy bags. This is until you can change them yourself. They can also explain to you how to put thin tubes into the urostomy to drain out the urine (self- catheterisation), if you need to do this.
Before you leave the hospital, your stoma nurse will give you some urostomy bags to take home. They might also set up an ordering system for you to get the bags from your local pharmacy. Or they may give you a prescription card to take it to your GP with the details of all the equipment you need.
After you leave the hospital, your stoma nurse might visit you at home to make sure that you are coping. Or you may have a district nurse visit instead. Do feel free to ask for their help with any questions or difficulties you have.
Types of urostomy bags
There are 2 main types of urostomy bags. A 1 piece system and a 2 piece system.
Your stoma nurse will help you to find out which system is best for you. The bags are very flat and do not smell or rustle as you move around.
Under ordinary clothes no one can tell you are wearing one. The bag can stay in place for a few days at a time. It has a tap at the bottom so you can empty it into the toilet.
The 1 piece system
The 1 piece system has the bag, seal and adhesive patch. It can last for 2 or 3 days.
The 2 piece system
The 2 piece system has a separate bag and adhesive wafer (flange).
The wafer is a soft, flat, plastic adhesive disc that sticks to the body. The bag clips onto the wafer. You can leave the wafer in place for up to 5 days and just change the bag.
What you need
To fit a new bag, at first you need to cut a hole in the wafer or adhesive patch to fit your stoma. When your stoma has settled in size, you can get bags that are pre-cut to fit.
The more accurate the fit, the less likely the bag is to leak. You get very good at this with practice.
You need to have:
- your new bag and wafer (if you use one)
- a measuring guide
- tissues or absorbent cloth
- warm water and wipes
- a disposal bag or newspaper
- a small mirror for looking at your stoma
You may also need:
- barrier cream
- adhesive paste (if you’re changing your wafer or one piece bag)
It’s helpful to keep everything that you need in a bag or in one place. That way, you won’t be halfway through and realise something important is missing.
How to change your bag
Your stoma nurse will show you how to change your bag. They make sure you know how to do it before you leave the hospital. Since bacteria grow quickly in urine, it’s important to empty the pouch often, at regular times.
Changing your bag can be difficult at first. With practice you start to learn what you need and what works best for you. It can also help if your partner or someone else close to you understands how to manage a urostomy.
When changing your bag, you don’t have to worry about keeping anything sterile (completely free of all germs). But you should be as hygienic as possible. You should:
- wash your hands
- get your new bag ready
- cut a hole in the wafer to fit your stoma if necessary
- drain your old bag
- peel the bag off carefully
- throw the bag away in your disposal bag or wrap it in newspaper
- clean round your stoma with warm water and wipes
- dry the skin thoroughly with tissues or absorbent cloth
- if you use barrier cream, massage it in well or it might stop your bag sticking to your skin properly
- check the size of your stoma with the measuring guide to make sure it hasn’t changed (your stoma nurse will show you how to do this)
- stick your new bag or wafer in place
- make sure the tap of the bag is closed
- put the old bag in the bin, well wrapped up (or your local authority may collect it)
- wash your hands again