Frequently Asked Questions: Caring for Your Urostomy

This information will help you learn how to care for your urostomy after your bladder surgery.

The most common skin problems happen if urine gets under the wafer or you have allergies to your ostomy products. Tell your WOC nurse if you have any problems with the skin around your stoma.

One common skin problem is a build-up of tissue on the skin around your stoma. The tissue may look greyish, purplish, wart-like, or have white spots. It can cause pain around your stoma. The build-up is caused by constant exposure of the skin to urine.

To resolve this problem, you may need to:

  • Cut or mold your wafer or get a different pre-cut wafer.
  • Use a different type of wafer.
  • Apply a barrier to your wafer (such as the Colly-Seel™ disc or Coloplast barrier ring).

You may also need to treat the skin right around your stoma each time you change your appliance. To do this:

  1. Mix ¼ cup of white vinegar with 1 cup of water.
  2. Soak a gauze pad in the mixture. Place the gauze pad on your skin for 20 minutes.
  3. Rinse your skin with water.
  4. Dry your skin well and apply a new wafer.

Another common skin problem is an allergic reaction with redness, itching, burning, welts, or discomfort. If you have an allergy, you will need to try a different brand of wafer and pouch.

If you develop a rash, tell your doctor or WOC nurse. They will give you suggestions for how to treat it.

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What are the signs and symptoms of a urinary tract infection? How do I avoid a urinary tract infection?

The signs and symptoms of a urinary tract infection are:

  • Foul smelling urine
  • Cloudy urine
  • Back pain
  • Nausea and vomiting
  • Loss of appetite
  • Fever

To prevent an infection:

  • Drink 6 to 8 (8-ounce) glasses of water or other liquids every day.
  • Limit the amount of alcohol and caffeine you drink.
  • Use a pouch with an antireflux valve and a night drainage system. This keeps urine from sitting on your stoma and causing an infection.
  • Empty your pouch when it’s ⅓ to ½ full.

You can also ask your doctor if you can take vitamin C (about 500 to 1,000 mg) and a sugar-free cranberry pill daily. These will increase the acidity of your urine and may help:

  • Prevent urinary tract infections
  • Decrease urine odor (smell)
  • Keep your skin from being damaged
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What color should my stoma be?

Your stoma should be a deep pink or red color all the time. If your stoma looks grey, brown, or black, contact your doctor right away.

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Is it normal for my stoma to bleed when I touch it or change my appliance?

Your stoma has many blood vessels and may bleed easily. It’s normal to see a small amount of blood on the gauze when you’re cleaning the stoma. The bleeding should stop on its own within a few minutes. If you take a blood thinner or aspirin, you may bleed more easily and for a longer time. Apply pressure to you your stoma to help stop the bleeding.

Call your doctor if the bleeding doesn’t stop after 10 to 15 minutes. You may need to go to MSK’s Urgent Care Center or your local emergency room. Your doctor will tell you what to do.

If there’s blood in your urine or coming from the inside of your stoma, call your doctor right away.

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The area around my stoma seems to bulge. Is this normal?

You may have a hernia. Often, the abdominal muscle around your stoma is weak. A loop of bowel (small intestine) can poke through the weak area, causing a bulge to form. If you see a bulge around your stoma, contact your doctor or WOC nurse.

Hernias often don’t have any symptoms. They aren’t treated unless they become blocked, twisted, or cause pain or other problems. Call your doctor right away if you have:

  • Nausea
  • Vomiting
  • Pain in your abdomen
  • Swelling in your abdomen

If you have a hernia, your WOC nurse can suggest a hernia support belt. These belts are custom made to fit your body.

You can also use a girdle or biking shorts to support the hernia. If you use these, you will need to cut out a hole for your ostomy pouch.

Using a hernia support belt, girdle, or biking shorts won’t cure the hernia, but it may keep the hernia from getting worse. They can also make you feel more comfortable and pull in the bulge to help your clothes fit better.

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What do I do if I develop leakage of urine under my wafer?

If urine is leaking under your wafer, change the wafer right away. If the leakage doesn’t stop, contact your WOC nurse. You may need a different system that fits better to avoid leakage.

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How do I clean my night drainage system?

Wash your night drainage system every day. You can use warm water or a mixture of ¼ cup white vinegar and 1 cup water. You can also buy cleansers such as M9™ Crystallizer cleansing system. After you wash the drainage system, let it air dry.

Replace your night drainage bag every 2 to 4 weeks.

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How do I find out about the latest products on the market?

You can find out about new products by:

  • Asking your WOC nurse.
  • Calling companies and asking for samples of their latest products.
  • Doing a search on the Internet for ostomy products.

You can also join an online chat room or local support group for people with ostomies. Often, other people dealing with the same issues know of products that might meet your needs.

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Can I wear a clothing belt?

Yes, you can wear a belt. You can also wear suspenders.

If you choose to wear a belt, wear it above or below your stoma. If the belt is directly on your stoma, it may cause irritation, bleeding, or an overgrowth of tissue.

You may want to wear a stoma guard along with the belt. It will help keep the belt from pressing on your stoma. You can order a stoma guard when you order your other supplies.

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How do I position the pouch?

You can position the pouch so it points down and can be tucked into your pants or underwear. It can also be folded, if you prefer. You can also try special underwear or concealment bands such as those from www.ostomysecrets.com or www.steathbelt.com.

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Is there anything I should do to prepare for medical tests?

Always carry extra ostomy supplies (pouch and wafer) with you. Many pharmacies and medical centers don’t have ostomy supplies, and you may need an extra set.

If you’re having a scan with contrast, bring an extra pouch and wafer, including an extra leg bag or night bag. For the scan, you will need to drink more liquids than usual. This will help the contrast leave your body, but it will also increase your urine output. You may need the extra pouch and wafer if you have a leak because of increased urine output. If you live an hour or more away from the hospital, empty your bag before leaving. You may also need to empty it on the trip home or use a leg bag. You may also want to keep a urinal or other container in your car in case of an emergency.

If you’re having chemotherapy, bring an extra pouch and wafer. Chemotherapy may cause your body to make more urine. It may also make your skin more sensitive or change the way the wafer sticks to your skin. You may need to change your wafer more often during chemotherapy to protect your skin and prevent leakage.

If you’re having a procedure where the doctor or nurse needs to access your stoma, you may need to switch to a different type of pouching system. For example, you may need to switch from a 1-piece system to a 2-piece system. Your doctor or nurse will talk with you before the procedure.

If you have any problems, contact your WOC nurse.

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Do I need to wear gloves when I change the pouch?

That is a personal choice. Just as you didn’t wear gloves when urinating before your ostomy, you don’t need to wear them now. However, you may prefer to wear gloves when you change their pouch because some urine could get on your fingers.

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