A urostomy is a surgical procedure that creates a new pathway for urine to exit the body when the bladder is unable to function properly or has been removed. This diversion typically involves using a small, isolated segment of the small intestine, most commonly the ileum, as a conduit. The ureters are connected to this segment, which is brought through the abdominal wall to form an opening called a stoma. Urine drains continuously through the stoma into an external collection pouch. The procedure itself does not generally shorten a person’s lifespan; the long-term outlook is almost entirely dependent on the underlying medical condition.
How the Underlying Condition Determines Longevity
The prognosis for a person with a urostomy is dictated by the reason the surgery was performed. In the majority of cases, a urostomy is created following a cystectomy (bladder removal) to treat muscle-invasive bladder cancer. For cancer patients, survival rates are primarily determined by the stage and grade of the tumor at the time of diagnosis.
If the cancer was localized and had not yet spread, the long-term outlook is significantly better. For instance, the five-year relative survival rate for localized bladder cancer is approximately 71%. Conversely, if the cancer had already spread to distant parts of the body, the prognosis is less favorable, with the five-year survival rate dropping to around 8%.
For individuals who undergo a urostomy for non-malignant conditions, the life expectancy is often comparable to that of the general population. These non-cancer causes include severe neurogenic bladder dysfunction, congenital defects like spina bifida, or bladder damage from trauma or radiation. In these cases, the urostomy preserves kidney function and improves quality of life, and it is not associated with a reduced lifespan.
Long-Term Health Management for Optimal Outcome
While the initial diagnosis sets the baseline for life expectancy, diligent long-term health management is necessary to achieve the maximum potential lifespan. The primary clinical focus after a urostomy is preventing complications that can negatively impact kidney function. The use of an intestinal segment introduces a risk of chronic or recurrent urinary tract infections (UTIs) and pyelonephritis, which can cause progressive kidney damage.
Maintaining adequate hydration is important, as sufficient fluid intake helps flush the system and minimizes the risk of stone formation and infection. Proper stoma care is also necessary because the intestinal segment secretes mucus. This care prevents blockages that could impede urine flow and cause a backflow of urine into the kidneys.
Regular, lifelong follow-up with a urologist or nephrologist is important for monitoring the health of the upper urinary tract. Specialists check for potential issues like ureteroenteric strictures (narrowings where the ureters connect to the conduit) and track kidney function over time. Long-term complications, such as a decline in renal function or metabolic disorders like hyperchloremic acidosis, require proactive medical management.
Quality of Life and Adaptation
A high quality of life is achievable for most people living with a urostomy. The surgery allows individuals to return to a full, active life, including exercise, travel, and social activities. Adaptation centers on mastering the practical skills of managing the external pouching system.
Specialized healthcare professionals, known as Wound, Ostomy, and Continence (WOC) nurses, help patients become self-sufficient in stoma care. Concerns regarding body image, intimacy, and relationships are common, but they often resolve as individuals gain confidence in managing their appliance. Connecting with an ostomy support group provides valuable peer insight and emotional support, facilitating social reintegration.