Urostomy is the passage of the urinary tract through the abdominal wall, bypassing the urethra, bladder, and sometimes even draining urine straight from the kidney. Urostomy is sometimes necessary in some cases of bladder and kidney diseases.

A urostomy(a cutaneous fistula) is a stoma within the urinary tract that allows urine to drain outside the body. Urostomy can be a combination of the skin of the kidney, ureters or bladder, and is performed when it is impossible, due to illness or injury, to naturally drain urine through the urinary tract. Urostomy, depending on the place of its emergence, is performed using various methods. A urostomy can be established by inserting a bladder catheter through the abdominal wall, extending the ureter, or inserting an ureteral catheter. A urostomy is also done by inserting a drain straight into the kidney. It all depends on what disease and what damage to the urinary system we are dealing with.

Main indications for a urostomy

The indications for a temporary or permanent urostomy may be stones in the ureters or kidneys, injuries and neoplasms of the bladder and ureters, injuries, narrowing of the urinary tract after radiotherapy of organs in the pelvis, removal of a prostate tumor in men, if damaged urethra.

  • obstruction in the outflow of urine from the kidney, caused by kidney or ureteral stones
  • malignant neoplasms of the urinary system
  • birth defects of the bladder and urinary tract
  • certain forms of neurogenic bladder dysfunction
  • urinary tuberculosis
  • radiation changes after radiotherapy
  • bladder and urinary tract injuries

Urostomy: types

Urostomy produced by percutaneous puncture

  • cystostomy or suprapubic-bladder fistula - usually only temporary drainage of urine from the bladder after percutaneous puncture
  • nephrostomy - usually only temporary drainage of urine from the kidney after percutaneous puncture of the phial-pelvic system

Surgically produced fistulas1.Urostomia open , i.e. no urinary incontinence:

  • ureterocutaneostomy or fistulauretero-cutaneous - generally definitive, usually bilateral anastomosis of the ureters with the cutaneous opening of the fistula on the abdomen her ureter with skin ureter
  • uretero-entero-cutaneostomy - definitive anastomosis of the ureters with the cephalic end of an isolated fragment of the intestine (iliac, sigmoid or transverse), which is a conduit, the distal end of which is fused with the fistula skin opening on the abdomen
  • vesicocutaneous fistula (vesicostomia) - usually temporary, usually used in children, anastomosis of the anteroposterior wall of the bladder with a skin opening of the fistula on the abdomen

2.Tight or continental adhesions , continental

  • continent reservoire - the final urine drainage from the intestinal reservoir, replacing the bladder - the ureters are implanted into the reservoir and the reservoir is connected to the skin opening
  • fistulas on the abdomen with an intestinal tract formed in such a way as to hold the urine and allowing periodic emptying of the reservoir with a catheter inserted into it through the tube
  • vesico-entero-cutaneostomy or vesico-entero-cutaneous fistula - definitive drainage of urine from the bladder through a tube made of an isolated loop of the iliac intestine (or appendix) and anastomotic on one side to the bladder and on the other side to the opening cutaneous abdominal fistula; the intestinal tract is formed in a way that ensures that the urine is kept and allows periodic emptying of the bladder with a catheter inserted into it through the tube
  • urethrostomy urethro-cutaneous fistula - generally definitive (usually temporary in boys) lateral anastomosis of the bulbar segment of the urethra with the fistula skin opening on the perineum

Urostomy: complications

The urostomy should be pink-red in color, almost round in shape and protrude about 1-3 cm above the surface of the abdominal skin. It should be slightly moist, excrete the correct content (urine, mucus), and the skin around the stoma should look like other parts of the abdomen. any change in the way your stoma looks, the skin around it or the urine you pass out should prompt you to contact your stoma nurse or doctor. The most common complications after a urostomy are:

  • swollen stoma
  • ostomy prolapse
  • retracting the stoma
  • stoma narrowing
  • parastomal hernia
  • ostomy ischemia and necrosis
  • contact eczema
  • allergic skin reaction
Worth knowing

Urostomy: dietPeople with urostomy are recommended to follow the general principles of he althy eating - the diet should be varied, with a limited amount of s alt. They should also control the color and appearance of urine, taking into account the consumed foods that naturally color the urine, e.g. beetroot, iron preparations, medications (Ginjal in blue, B vitamins in yellow), and remember that too little fluids make the urine urine is dark and concentrated, and patients with urostomy should also take particular care to drink at least 2 liters of fluid a day and avoid behaviors and products that may contribute to the formation of stones in the urinary tract, such as:

  • reduce consumption of oxalate (green vegetables)
  • control the amount of calcium in your diet
  • reduce red meat consumption
  • reduce the consumption of alkaline foods (white meat, egg white)

Alcohol can be consumed in spite of a urostomy, but only in small amounts.

Category:

Urology and Nephrology