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Emptying and washing out an internal urine pouch

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This page tells you about looking after an internal urine pouch (continent urinary diversion). There is information about

 

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Emptying and washing out your continent urinary diversion

If you have had your bladder removed and an internal pouch created to hold the urine this is called a continent urinary diversion. You will need to learn how to empty urine from the pouch and wash it out. On your abdominal wall you will have a small spout like hole called a stoma for the urine to come out. The stoma acts as a valve to stop the urine coming out. 

Emptying the pouch

You empty urine from the pouch by putting a tube called a catheter into the stoma. This is called self catheterisation. You start doing this once the stoma and pouch has healed. This is normally 2 to 3 weeks after your operation. Your stoma nurse will show you how to do it. 

You don’t have to keep everything sterile when you drain your urine. But it’s important to be as clean as possible to avoid getting an infection. To start with, you will need to empty the pouch every 2 hours or so. As the pouch stretches, you will be able to cut this down to every 4 to 6 hours during the day. 

Washing out the pouch

Mucus can build up in the pouch and so you will need to wash this out. Your stoma nurse will advise on how often to do this, as it can vary.Washing out the pouch is called irrigating it. You put a catheter into the pouch and then put water or salt water through this into the pouch using a syringe. Then you draw the liquid out with the syringe. You repeat this until the liquid is clear. 

 

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Looking after an internal urine pouch

If you have had your bladder removed and an internal pouch created to hold the urine this is called a continent urinary diversion. You will need to learn how to empty urine from the pouch and wash it out. On your abdominal wall you will have a small spout like hole called a stoma for the urine to come out. The stoma acts as a valve to stop the urine coming out. 

You will begin emptying the pouch and washing it out once the pouch and stoma have healed. This is normally 2 to 3 weeks after your operation. Your stoma nurse will show you how to do this. This check list can help you get used to it.

 

Emptying the pouch

You empty urine from the pouch by putting a tube called a catheter into the stoma. This is called self catheterisation. Your stoma nurse will show you how to do it. 

To start with, you will need to empty the pouch every 2 hours or so. As the pouch stretches, you will be able to cut this down to every 4 to 6 hours during the day. 

You will need

  • A disposable catheter
  • Some lubricating gel
  • A container to drain urine into

Diagram showing self catherisation of a urinary diversion Copyright © CancerHelp UK

At first, your nurse may ask you to drain the urine into a container. This is so that you can keep a record of how much urine you are passing each time. After a while you will be able to drain the urine straight into the toilet. You don't have to worry about keeping anything sterile (completely free from all germs) when you catheterise. But try to be as clean as possible. You want to keep the risk of introducing an infection as low as you can. It is best not to touch the end of the catheter that you are going to put into the stoma.

  • Wash your hands
  • Open the catheter packaging
  • Open the gel
  • Take out the catheter and moisten the blunt end with water or gel (unless it is pre lubricated)
  • Gently feed the catheter into your stoma
  • Keep feeding the catheter in until urine starts to come out
  • Drain the urine into the container or toilet
  • When no more urine comes out, gently draw the catheter out of the stoma
  • Throw the catheter away
  • Wash your hands

If you have trouble getting the catheter in, try pulling it back a bit and gently pushing it in again. It can help to roll the catheter between your fingers as you put it in.

 

Washing out the pouch

Mucus can build up in the pouch and so you will need to wash this out. If you don't wash it out regularly, the mucus could stop the stoma draining properly. Washing out the pouch is called irrigating the pouch. Your stoma nurse will advise on how often to do this, as it can vary.

As well as the catheter and gel for emptying your pouch, you will need

  • Boiled, cooled water for irrigating
  • A 50ml catheter syringe

First, empty the urine out of your pouch with the catheter as described above. But leave the catheter in after the urine has all drained out. Then

  • Pull up the irrigating solution into the syringe
  • Fit the syringe onto the end of the catheter
  • Gently push the end of the syringe in so that the water is pushed into your pouch
  • Withdraw the water back into the syringe by slowly pulling out the plunger
  • Disconnect the catheter and empty the contents into the toilet
  • Fill the syringe again and repeat
  • Keep irrigating and emptying the syringe until there is no more mucus and the fluid that comes out is clear
  • Gently pull out the catheter and throw it away

Your doctor or stoma nurse may prefer you to use sterile salt water solution (saline) or bottled water. Different people may prefer one solution or another, but they are all okay to use. If you are away from home, you can use bottled water to wash out the pouch.

The amount of mucus your pouch produces may decrease with time. So you may be able to irrigate less often.

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Updated: 25 October 2013