and how to solve them?

What is a urostomy?

Bladder cancer is a common malignant tumor of the urinary system, and urostomy is the primary treatment for muscle-invasive bladder cancer. After urostomy, urination changes from the urethral opening of the perineum to the abdominal wall stoma. The urostomy is usually located under the right abdomen. It is an opening formed by surgically introducing one end of the intestinal tube to the body surface and then two. The ureter is connected to the segment of the ileum that is cut out, and a urostomy is not a disease but an artificial opening that facilitates the passage of urine. Urine discharge is uncontrolled, so a urostomy bag is required to collect urine.

There are two types of urostomy depending on the surgical method :

1. Enterocystostomy: After removal of the bladder, urine is drained from the abdomen through the ureter through a section of the ileum, and the ileum is pulled out to the belly's surface and sutured on the skin.

2. Ureterocutaneous stoma: Pull the ureter out of the abdomen and suture it directly on the skin.

Urinary stoma prone to problems:

Because of the continuous discharge of excreta, especially the low and flat nipple of the ureterostomy, it is very prone to leakage. Once the leakage occurs, the excrement will erode the skin and cause problems.

1. Dermatitis around stoma: A common complication in the stoma occurs at any stage after surgery. Since urine often contacts the skin, harmful substances in urine penetrate the skin and destroy the skin barrier to form irritant dermatitis. Mechanical dermatitis can also develop due to frequent replacement and forced peeling.

2. Retraction/invagination: the bowel's length is insufficient, and the size of the everted bowel is inadequate, which leads to the retraction of the enterostomy caused by the evacuation of the stomal bowel before the passage of the bowel. Excessive weight gain after surgery and abdominal fat around the stoma can cause the stoma to retract.

3. Uric acid crystals around the stoma: It is a white powder crystal formed by alkalizing urine, which adheres to the skin around the stoma.

4. Granulation tissue hyperplasia:

Because epidermal cells are stimulated by urine for a long time, the cortex is thickened, irregular, or a few millimeters above the skin, pigmentation, dark brown, gray-black or gray-white, sometimes very painful, and easy to ooze after injury.

Care of urostomy complications:

Dermatitis around the stoma:

Rinse with normal saline and wipe dry, then apply stoma skin care powder to promote epidermal growth and reduce inflammation. After a few minutes gently wipe off excess powder. Apply skin protectant. Finally, apply leak-proof plaster.The ostomy pouch is replaced every other day, and the use of irritating items should be avoided as much as possible so as not to aggravate dermatitis.

Retraction/Invagination: Fill it with anti-leakage paste, then choose a convex chassis ostomy pouch.

Uric acid crystals around the stoma: After diluting with white vinegar and normal saline, wipe the surrounding uric acid crystals with gauze, avoid the mucous membrane of the intestinal stoma, and pay attention to the acidity and alkalinity of the food. Avoid ostomy crystals by drinking plenty of water and supplementing with vitamin C-rich juices to dilute and acidify your urine.

Granulation tissue hyperplasia: prevent the leakage of the stoma chassis. Once the leakage of the ostomy bag is found, it needs to be replaced immediately. The ostomy bag should be emptied once every 4-6 hours, which should not be too long. The stoma is 1-2mm larger.

Choose a stoma skin protector with a good anti-corrosion effect, which can keep the skin dry, block excretion, reduce leakage, and double protect the skin.

How can I prevent the problems of the above urostomy?

1. Appropriate ostomy pouchs and stoma products can be used according to skin conditions.

Longterm Medical One-Piece Urostomy pouch (404) Features:

1. One-sided opaque with hot-rolled non-woven backing.

2. Anti-reflux design: It will not cause urine to overflow from the rubber ring due to lying down or on your side.

3. EVA material discharge valve: good elasticity, soft shock absorption, anti-oxidation, external drainage bag.

Longterm Medical Two-Piece Urostomy pouch Features:

1. The bag body is removable.

2. Facilitate the management of urinary tract crystals.

There are many types of ostomy pouchs on the market, and it is essential to choose an ostomy pouch that suits you. Generally, the two-piece chassis can be used continuously for about five days. It is recommended to replace the ostomy pouch every day. After removing it. Clean it and dry it before using it until it is damaged. If there is urine leakage, replace it in time. Drink as little water as possible before returning the ostomy pouch and going out.

Guidelines for the care of a urostomy:

1. Under normal renal function, ensure that the daily water intake is 1500-2000ml. Eat more fresh vegetables and fruits rich in VC.

2. Choose an ostomy pouch with an anti-reflux device.

The urostomy directly communicates with the outside world, and it is easy to breed bacteria, so it is necessary to prevent it actively.

To use an ostomy pouch with an anti-reflux device, empty it when it is 1/3 or 1/2 full with urine.

3. Pay attention to cleanliness and hygiene. When changing stoma products, try to clean and disinfect your hands as much as possible.

4. Change the ostomy pouch frequently to reduce bacterial growth. When the urine in the ostomy pouch is 1/3 full, it will be discharged in time.

5. During daily life or exercise, avoid excessive stretching, twisting, bending, and partial slap of the stoma to prevent the tube from falling off.

For more information on Innomed® ostomy bag, refer to the previous articles. If you have customized needs, you are welcome to contact us; we will serve you wholeheartedly.

At Longterm Medical, we transform this data by innovating and developing products that make life easier for those who need loving care.

references:

1. Zhuang Qinfang, Modern Journal of Integrated Traditional Chinese and Western. Medicine 2011 Del, 20(35)

Editor: kiki Jia
Date: June22,2022