After surgery to remove your bladder, you might have a small hole called a stoma on your tummy (abdomen). Your urine now comes out through the stoma.
You will need to learn how to look after it before you leave the hospital. The nurses and your stoma nurse can show you how to do it.
Stoma nurses have experience in looking after different types of stomas. They help support and teach you how to look after yours.
You might see your stoma nurse before the operation. They will show you the different types of urostomy bags you can use. They might give you a stoma kit to practice on first.
After your operation, your nurse will change your urostomy bags. This is until you can change them yourself. They'll also explain how to put thin tubes into the urostomy to drain out the urine (self catheterisation), if you need to do this.
Before you leave the hospital, you'll get some urostomy bags to take home. They might also set up an ordering system for you to get the bags from your local pharmacy. Or they may give you a prescription card to take it to your GP with the details of all the equipment you need.
After you leave the hospital, your stoma nurse might visit you at home to make sure that you are coping. Or you may have a district nurse visit instead. Do ask for their help with any questions or difficulties you have.
You’ll have the contact details of your nurse to contact if you have any issues or questions whilst you’re at home.
Types of urostomy bag
There are 2 main types of urostomy bag. A 1 piece system and a 2 piece system.
Your stoma nurse will help you to find out which system is best for you. The bags are very flat and do not smell or rustle as you move around.
Under ordinary clothes no one can tell you are wearing one. The bag can stay in place for a few days at a time. It has a tap at the bottom so you can empty it into the toilet.
The 1 piece system
The 1 piece system has the bag, seal and adhesive patch. It can last for up to 3 days.
The 2 piece system
The 2 piece system has a separate bag and adhesive wafer (flange).
The wafer is a soft, flat, plastic adhesive disc that sticks to the body. The bag clips onto the wafer. You can leave the wafer in place for up to 5 days and just change the bag every 2 to 3 days.
What you need
To fit a new bag, at first you need to cut a hole in the wafer or adhesive patch to fit your stoma. When your stoma has settled in size, you can get bags that are pre cut to fit.
The more accurate the fit, the less likely the bag is to leak. You get very good at this with practice.
What you need:
- your new bag and wafer (if you use one)
- a measuring guide
- tissues or absorbent cloth
- warm water and wipes
- a disposal bag or newspaper
- a small mirror for looking at your stoma
You may also need:
- barrier cream
- adhesive paste (if you’re changing your wafer or one piece bag)
It’s helpful to keep everything that you need in a bag or in one place. That way, you won't be halfway through and realise something important is missing.
How to change your bag
Your stoma nurse will show you how to change your bag. They make sure you know how to do it before you leave the hospital.
Changing your bag can be difficult at first. With practice you start to learn what you need and what works best for you. It can also help if your partner or someone else close to you understands how to manage a urostomy.
When changing your bag don't worry about keeping everything sterile (completely free of all germs). But you should be as hygienic as possible. You should:
- wash your hands
- cut a hole in the wafer to fit your stoma
- make sure the tap is closed on the new bag
- drain your old bag
- peel the old bag off carefully
- throw the bag away in your disposal bag or wrap it in newspaper
- clean round your stoma with warm water and wipes
- dry the skin thoroughly with tissues or absorbent cloth
- if you use barrier cream, massage it in well or it might stop your bag sticking to your skin properly
- check the size of your stoma with the measuring guide to make sure it hasn't changed (your stoma nurse will show you how to do this)
- peel off the paper from the flange
- stick your new bag or wafer in place
- press down on the flange with your fingers to make sure its sealed to your ski and there are no creases
- place your rubbish in the bin
- wash your hands
Stoma appliances are products such as urostomy bags, irrigation systems, and catheters to help you care for your stoma.
Some organisations can give you advice and support. They can arrange for you to meet other people with urostomies and keep up to date with new ideas. Meeting someone who has been through what you are experiencing might help you to cope. They know what is important to tell and can answer your questions from first hand experience.
The Urostomy Association can arrange for you to meet with other people with urostomies. Members can visit you before and after your operation to support you and give advice on how to cope.