Managing Your Urostomy
The following guidelines will make care of your urostomy easier. Keep this information close by for quick reference.
- Drink at least 6 to 8 glasses of water daily. This helps keep your urine at its proper acid level, reduces salt formation, and helps prevent the growth of bacteria.
- Foods like asparagus, garlic, onions, and fish produce odor. Although your pouch is odor-proof, if you eat these foods, you may notice a stronger odor when emptying your pouch. If this is a concern, you may want to limit these foods in your diet.
- To reduce odor, rinse your pouch daily (if you are wearing a two-piece system). Rinse your drainage bag after emptying it. Once a week, wash out your night drainage bag using a few drops of liquid dish soap and warm water. Rinse the bag thoroughly with warm water. Mix 1/2 cup of white vinegar with 1/2 cup of water. Rinse the bag with this solution. You may leave the bag soaking in this solution during the day. This will help deodorize the bag and kill bacteria. Use a funnel to help rinse the bag.
- Empty your pouch every 3 to 4 hours or when it is 1/3 full. When your pouch is over 1/3 full, the weight of the pouch may loosen the seal. Emptying your pouch frequently will help protect the seal.
- Normally, your urine contains some mucus shreds. If mucus clogs the drain spout of your pouch, drink more fluids to help unclog it. You may also purchase Marlen Muco-Sperse to dissolve clogged mucus. Your ET (enterostomal therapy)/ostomy nurse can tell you how to order this product.
- The best time to change your pouch is in the morning before eating or drinking, or 2 to 3 hours after you have had fluids.
- If your doctor orders a urine sample, it should be taken directly from the stoma with a catheter by a trained health care professional.
Applying the pouching system
To apply your pouch, follow these steps:
- Place all your equipment close at hand before removing your pouch.
- Wash your hands.
- Stand or sit in front of a mirror. Use the position that works best for you. Remember that you must keep the skin around the stoma wrinkle-free for a good seal.
- Gently remove the used pouch (one piece system) or the pouch and old wafer (two-piece system). Empty the pouch into the toilet.
- Wash the stoma itself and the skin around the stoma. Your stoma may bleed a little when being washed. This is normal. Rinse and pat dry. You may use a wash cloth or soft paper towels (like Bounty), mild soap (like Dial, Safeguard, or Ivory), and water. Avoid soaps that contain perfumes or lotions.
- For a new pouch (one-piece system) or a new wafer (two-piece system), measure your stoma using the stoma guide provided in each box of supplies (Fig. 1).
- Trace the shape of your stoma onto the back of the new pouch or the back of the new wafer (Fig. 2). Cut out the opening (Fig. 3). Remove the paper backing and set it aside.
- Optional: Apply a skin barrier powder to the surrounding skin if it is irritated (bare or weeping), and dust off the excess.
- Optional: Apply a skin-prep wipe (such as Skin Prep or All-Kare) to the skin around the stoma, and let it dry. Do not apply this solution if the skin is irritated (red, tender, or broken) or if you have shaved around the stoma.
- Hold the pouch (one-piece system) or wafer (two-piece system) with the sticky side toward your body. Make sure the skin around the stoma is wrinkle-free. Center the opening on the stoma, then press firmly to your abdomen (Fig. 4). Look in the mirror to check if you are placing the pouch, or wafer, in the right position. For a two-piece system, snap the pouch onto the wafer. Make sure it snaps into place securely.
- Place your hand over the stoma and the pouch or wafer for about 30 seconds. The heat from your hand can help the pouch or wafer stick to your skin better.
- Add deodorant (such as Super Banish or Nullo) to your pouch. Other options include food extracts such as vanilla oil, peppermint extract, etc. Add approximately 10 drops of the deodorant to the pouch. Note: Do not use toxic chemicals or commercial cleaning agents in your pouch. These substances may harm the stoma.
- Optional: For extra seal, apply tape to all four sides around the pouch or wafer, as if you were framing a picture. You may use any brand of medical adhesive tape.
- Change your pouch every 5 to 7 days. Change it immediately if leakage occurs.
- Wash your hands.
If you are wearing a two-piece system, you may use two new pouches per week and alternate them. Rinse the pouch with mild soap and warm water and hang it to dry for the next day. Apply the fresh pouch. Alternate the two pouches like this for a week. After a week, change the wafer and begin with two new pouches. Place the old pouches in a plastic bag, and put them in the trash.
Applying your pouch
- You may stand or sit to apply your pouch.
- Keep the skin where you apply the pouch wrinkle-free. If the skin around the pouch is wrinkled, the seal may break when your skin stretches.
- If hair grows close to your stoma, you may trim off the hair with scissors, an electric razor, or a safety razor.
- Always have a mirror nearby so you can get a better view of your stoma.
- When you apply a new pouch, write the date on the adhesive tape. This will remind you of when you last changed your pouch.
Changing your pouch
- The best time to change your pouch is in the morning, before drinking anything. Your stoma can work at any time, but it will work more after drinking.
- Empty the contents of the used pouch into the toilet. Gently remove the seal. Place the pouch in a plastic bag and put it in the regular trash for disposal. Do not flush the pouch down the toilet, unless the label says it is flushable.
- You may shower or bathe with your pouch on or off. Remember that your stoma may work during this time.
- The materials you use to wash your stoma and skin around it should be clean, but they do not need to be sterile.
Wearing your pouch
- During hot weather, or if you perspire a lot in general, wear a cover over your pouch. This may prevent a rash developing on your skin under the pouch. Pouch covers are sold at ostomy supply stores.
- Wear the pouch inside your underwear for better support.
- Watch your weight. Any gain or loss of 10 to 15 pounds or mare can change the way your pouch fits.
Going away from home
- Carry wet wipes or extra tissues to use in public bathrooms.
- Carry an extra pouching system with you at all times.
- Never keep ostomy supplies in the glove compartment of your car. Extreme heat or cold can damage the skin barriers and adhesive wafers on the pouch.
- When you travel, carry your ostomy supplies with you at all times. Keep them within easy reach. Do not pack ostomy supplies in baggage that will be checked or otherwise separated from you, because your baggage might be lost. If you’re traveling out of the country, it is helpful to have a letter stating that you are carrying ostomy supplies as a medical necessity.
- If you need ostomy supplies while traveling, look in the yellow pages of the telephone book under “Surgical Supplies.” Or call the local ostomy organization to find out where supplies are available.
- Do not let your ostomy supplies get low. Always order new pouches before you use the last one.
When to call the doctor
Call the doctor if you have any of the following symptoms:
- Urine that is cloudy, bloody, or has a bad odor
- Purple, black, or white stoma
- Excessive bleeding from your stoma
- Sudden shrinking or swelling of your stoma by more than 1/2 inch
- Pulling inward of your stoma below skin level
- Severe skin irritation or deep ulcers
- Bulging or other changes in your abdomen
- Decrease in the amount or urine you normally pass in a day
My doctor’s name: ________________________________________________________________________
My doctor’s telephone number: ______________________________________________________________
When to call your ostomy nurse
Call your ET/ostomy nurse if any of the following occurs:
- Frequent leaking of your pouching system
- Change in size or appearance of your stoma, causing discomfort or problems with your pouch
- Skin rash or rawness
- Weight gain or loss that causes problems with your pouch
My ET/ostomy nurse’s name: _______________________________________________
My ET/ostomy nurse’s telephone number: _____________________________________
Your pouching system
Equipment (check one)
one piece ________ two piece _________
Powder (optional) ____________________________________
Tape (optional) _______________________________________
Adapter tubing ________________________________________
Night drainage bag or bottle______________________________