What is a urostomy?
A urostomy is a surgical procedure that creates an opening in the abdominal wall to allow urine to pass out of the body. This is necessary when the bladder is either not functioning properly or has been removed due to a disease, such as bladder cancer. This procedure helps manage urinary function and can significantly improve the quality of life for people with severe bladder conditions.
At Penn Medicine, we have extensive experience with urostomy surgery and care. Our team of specialists—including urologists, oncologists, urostomy care nurses, and surgeons—work together to ensure you have fewer complications and the best possible outcome.
How a urostomy works
A urostomy works by rerouting urine from the kidneys to a urine collection pouch. There are several steps involved:
- Creating an opening in your abdominal wall, called a stoma
- Redirecting urine from the kidneys to the stoma
- Attaching or creating a urine collection pouch
- Maintaining the urine collection pouch
Types of urostomies
There are several types of urostomies, each with different methods of diverting urine. The most common are the ileal conduit, continent urostomy, and neobladder.
This is the most common type of urostomy. During an ileal conduit urinary diversion, a small piece of the ileum (part of the small intestine) is used to create a conduit (tube) for urine. Your surgeon will remove a segment of the ileum and attach one end to the tubes that carry urine from the kidneys, called the ureters. The other end is connected to the urostomy stoma in the abdominal wall. Urine flows from the kidneys, through the ureters, into the ileal conduit, and through the stoma into an external collection pouch. These pouches are sometimes called urostomy bags or bladder bags. They’re designed to be discreet and can be emptied as needed.
This method creates a new reservoir inside the body. There are several types—for example, Kock pouch, Indiana pouch, and Mitrofanoff pouch—and each type uses different tissues from within the body to make the urine reservoir and attach it to the stoma. The internal pouch must be emptied several times a day using a catheter.
This method involves creating a neobladder, a new bladder made from a piece of the intestine. A section of the intestine is surgically positioned inside the body where the original bladder was located. This new bladder is connected to the urethra, the tube that removes urine from the body. The ureters are attached to the neobladder, allowing urine to flow into it. You can urinate through the urethra, much like natural urination, though you may need to learn techniques to ensure the neobladder is fully emptied. With this method, a stoma is not needed.
Who is a candidate for a urostomy?
Your doctor may recommend a urostomy if:
- You had your bladder removed via cystectomy due to cancer or another disease
- You have severe bladder dysfunction or damage due to injury
- You were born with abnormalities affecting the urinary system
- You experience urinary incontinence that can’t be controlled by other treatments
What to expect during a urostomy
Before your urostomy, your doctor will explain the procedure and answer your questions. Your care team will provide instructions on preparing for the surgery.
During the procedure, you can expect:
- You’ll be given general anesthesia, so you’ll be asleep and pain-free during the surgery.
- Your surgeon will make an incision in your abdomen.
- A segment of your intestine is removed and restructured to create a passageway for urine.
- A collection bag, if used, is then attached to the stoma to collect urine.
- The surgery takes about four hours.
Recovering from a urostomy
Most patients stay in the hospital for several days to ensure proper recovery from urostomy surgery.
Before you go home, you’ll receive training on how to care for your stoma or neobladder. Your Penn Medicine care team will give you tips on maintaining hygiene and preventing skin irritation around the stoma if you have one. Additionally, follow-up appointments will be scheduled to monitor your recovery and address any questions or concerns you may have.
Experienced surgeons ensure better urostomy outcomes
Penn Medicine surgeons are experts in gastrointestinal care. They’ve honed their skills with years of training and experience performing urostomies. Treating a high number of patients allows them to anticipate and manage potential complications more effectively, leading to improved care, fewer complications, and better overall results. In addition, their expertise enables them to customize the procedure to fit your needs, further enhancing your quality of life and post-surgery recovery.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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