The term “stoma” means mouth or opening. A urinary stoma, or a urostomy, is a pouch made using the patient’s small intestine to allow urine to drain outside of the body without passing through the bladder.
Complications with the urinary stoma may include skin problems, irritation, leaks, bleeding, and urinary tract infection (UTI).
Skin Complications
Having a urinary stoma can cause soreness and discomfort. Patients may also experience leaks that could lead to further skin damage.
Skin complications may be caused by an ill-fitting stoma appliance. To prevent this, it’s important to cut the right-sized hole in the stoma bag that fits snugly around the stoma and doesn’t leave any gaps. Patients should regularly measure the size of their stoma to make sure it hasn’t grown or shrunk in size. Fluctuations in weight may affect the size of the stoma. The gaps can be filled with stoma paste to prevent leaks.
A rash or allergic reaction to the wafer of the bag can cause itching and weeping of the skin. Skin irritation can make it difficult for the stoma bag to adhere to the skin, causing leaks. A nurse may offer tips and product recommendations for treating the rash.
Stoma Leakage
A poorly-fitted stoma bag can lead to leakage. Unexpected, quick filling or loose output may also cause leakage. Occasional leaks are not a cause for concern, but patients should understand that an upset stomach, change in diet, anxiety, and stress can affect output and increase the risk of leaks.
To prevent stoma leakage, patients should check for gaps in the wafer and make sure the hole fits snugly around the stoma.
Urostomy Bag Leakage
The bag may leak if:
- The skin is too moist
- There is a dip or crease in the abdomen
- The stoma is flat or retracted
Patients should make sure their skin is dry before applying a stoma pouch. If there’s a dip or crease in the abdomen, patients should try using paste, washers, or different pouches to help the adhesive gently conform to the body’s shape. If the stoma is flat or retracted, the patient may need a stoma pouch with a convex flange.
Bleeding Stoma
Stomas can bleed easily because they are very vascular and have a lot of blood vessels near the opening. Rubbing the bag around the stoma can cause bleeding, which is not cause for concern. However, if the bleeding is coming from inside the stoma, then the patient may have intestinal bleeding. In these cases, the patient should contact their physician.
Urinary Tract Infection (UTI)
It is possible for patients with a stoma to develop a UTI. Symptoms of a UTI include:
- Cloudy or foul-smelling urine
- Urine that is thicker or darker than usual
- Shivering
- High temperature
- Nausea
- Vomiting
Tips for Preventing Urinary Stoma Complications
To keep the stoma healthy, patients should:
- Drink cranberry juice
- Eat yogurt with live cultures
- Drink plenty of water
- Properly clean the stoma
- Carefully apply the pouch
- Use specialized gels and washes to prevent urinary crystals