A urostomy is a surgical procedure that creates an alternate pathway for urine to exit the body. This procedure becomes necessary when the bladder can no longer function properly or has been removed.
Understanding a Urostomy
A urostomy involves creating an opening, known as a stoma, on the abdomen. This surgically created opening diverts urine from the kidneys, allowing it to pass out of the body. The most common type of urostomy is an ileal conduit, which uses a small segment of the small intestine (ileum) to form a channel. The ureters, which carry urine from the kidneys, are connected to this intestinal segment, and the other end is brought out through the abdominal wall to create the stoma.
Since the stoma does not have a muscle to control urine flow, urine drains continuously. A collection pouch, often called an ostomy bag, is worn over the stoma to gather the urine. Reasons for a urostomy can include bladder cancer, which often necessitates bladder removal, or other conditions such as spinal cord injuries, congenital defects, or severe bladder dysfunction.
Influences on Life Expectancy
The urostomy procedure itself typically does not shorten an individual’s life expectancy. Instead, the primary factor determining longevity is the underlying medical condition that made the urostomy necessary. For example, if the urostomy was performed due to advanced bladder cancer, the prognosis is largely influenced by the stage and aggressiveness of the cancer, rather than the urinary diversion itself.
An individual’s overall health status at the time of surgery also significantly affects the outlook. Factors such as age, the presence of other chronic diseases like heart disease or diabetes, and general physical condition can influence recovery and long-term well-being. Post-operative complications, while not always life-threatening, can impact recovery and health. These might include infections, kidney issues, or parastomal hernias.
Some individuals may experience metabolic issues or blockages from scar tissue. However, for many, a urostomy can improve overall quality of life by resolving severe bladder problems, enabling them to live longer and more comfortably than they would have without the surgery. This surgical intervention often allows individuals to manage their condition effectively and resume many daily activities.
Life with a Urostomy
Adapting to life with a urostomy involves learning how to manage the stoma and the collection pouch. The stoma has no nerve endings, so it does not cause pain. Urine drains into a waterproof, odor-proof pouch that adheres to the skin around the stoma. This pouch needs to be emptied regularly, typically when it is one-third to half full.
Pouching systems vary, with options including one-piece or two-piece systems, allowing individuals to find what best suits their body shape and lifestyle. Proper hygiene, including cleaning the skin around the stoma and ensuring a secure fit of the pouch, is important to prevent skin irritation. Most individuals can maintain an active lifestyle, participate in social activities, and wear their usual clothing, as the pouch lies flat against the body and is not easily noticeable.
While there may be an initial period of psychological adjustment, many individuals find that living with a urostomy allows them to lead fulfilling lives. Support from healthcare professionals, such as ostomy nurses, and connecting with others who have undergone similar procedures can aid in this adaptation process. Dietary restrictions are generally minimal, though maintaining good hydration is often encouraged.
Ongoing Care and Prognosis
Ongoing care for individuals with a urostomy involves regular medical follow-ups to monitor overall health and address concerns. This includes monitoring kidney function and regular checks of the stoma’s health.
Specialized healthcare providers, such as ostomy nurses, play a significant role in long-term management. They provide guidance on stoma care, pouch selection, and troubleshooting common issues. With good management and adherence to care routines, many individuals with a urostomy experience a good quality of life for many years. The long-term outlook is primarily influenced by the initial underlying condition that necessitated the surgery.