| Urostomy | |
|---|---|
_CRUK_124.svg) Diagram showing how a urostomy is made using an ileal conduit technique | |
| Specialty | Urology |
| MeSH | D014547 |
A urostomy is a surgical procedure that creates a stoma (artificial opening) for the urinary system. A urostomy is made to avail for urinary diversion in cases where drainage of urine through the bladder and urethra is not possible, e.g. after extensive surgery or in case of obstruction.[1]
Techniques
edit
Techniques include:
- Ileal conduit urinary diversion, in which the ureters are surgically resected from the bladder and a ureteroenteric anastomosis is made in order to drain the urine into a detached section of ileum (a part of the small intestine). The end of the ileum is then brought out through an opening (a stoma) in the abdominal wall. The urine is collected through a bag that attaches on the outside of the body over the stoma.
- Indiana pouch
A "continent urostomy" is an artificial bladder formed out of a segment of small bowel. This is fashioned into a pouch, which can be emptied intermittently with a catheter. It avoids the need for a stoma bag on the urostomy.
Routine care
editThe appliances are usually changed at a time of low fluid intake, such as early in the morning, where less urine production makes changing easier.[2] Maintaining healthy peristomal skin is a key aspect of urostomy care, as contact with urine can cause irritation and skin breakdown. A 2008 systematic review found that peristomal skin problems are among the most commonly reported complications across all ostomy types.[3]
Indications
editUrostomy is most commonly performed after cystectomy, such as may be necessary in, for example, bladder cancer. Other indications include severe kidney disease, accidental damage or injury to the urinary tract, surgical complications because of non-related pelvic or abdominal surgery, congenital defects that cause urine to back up into the kidneys, or urinary incontinence.[4]
Epidemiology
editUrostomy is the least common of the three primary ostomy types. A 2023 prospective study found that urostomies accounted for approximately 9.7% of all ostomy surgeries, compared with 55.1% for colostomies and 35.2% for ileostomies.[5]
See also
editReferences
edit- ^ Urostomy Archived 2016-11-19 at the Wayback Machine from Cancer.org (American Cancer Society).Last Medical Review: 03/17/2011. Last Revised: 03/17/2011
- ^ Taylor, C. R., Lillis, C., LeMone, P., Lynn, P. (2011) Fundamentals of nursing: The art and science of nursing care. Philadelphia: Lippincott Williams & Wilkins, page 1254-1255.
- ^ Salvadalena, Ginger (2008). "Incidence of complications of the stoma and peristomal skin among individuals with colostomy, ileostomy, and urostomy: a systematic review". Journal of Wound, Ostomy and Continence Nursing. 35 (6): 596–607. doi:10.1097/01.WON.0000341473.86932.89. PMID 19018200.
- ^ "Urostomy: Purpose, Procedure, Risks & Recovery". Cleveland Clinic. Retrieved 2026-03-27.
Reasons you may need a urostomy include: bladder cancer, other pelvic cancers, nerve damage to the bladder, birth defects, chronic infection or inflammation and severe urinary incontinence.
- ^ Martín-Gil, Belén; Rivas-González, Noel; Santos-Boya, Teresa; López, María; Jiménez, José-María; Redondo-Pérez, Natán; del Río-García, Isaías; Berdón-Berdón, María; Fernández-Castro, Mercedes (2024). "Changes in the quality of life of adults with an ostomy during the first year after surgery". International Wound Journal. 21 (3) e14456. doi:10.1111/iwj.14456. PMC 10898385. PMID 37963817.
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