Changing Your Urostomy Pouching System in the Hospital

This information will help you change your 2-piece disposable urostomy pouching system while you’re in the hospital. A urostomy pouching system is sometimes called a urostomy appliance.

For more information about your urostomy and caring for your urostomy pouching system, read the resource About Your Urostomy. You can also watch the video How to Change Your Urostomy Pouching System in the Hospital.

Back to top

Changing Your Pouching System

You will need to change your pouching system about every 3 days. It’s best to change it in the morning before you eat or drink anything, when there’s less urine (pee) coming from your stoma. If your pouching system is leaking, change it right away.

You will be in your hospital bed the first few times you change your pouching system. Your nurse will help you. Once you’re comfortable standing up for 15 to 20 minutes, you can change your pouching system wherever you’re most comfortable. Most people like to change it in the bathroom in front of the mirror.

Supplies

Gather your supplies before you start. You will need:

  • Adhesive remover spray
  • 4x4 gauze pads
  • Warm water
  • Measuring guide
  • Pen or marker
  • Scissors (if you’re using a cut-to-fit wafer)
  • New wafer
  • New pouch
  • Low-pressure adaptor
  • Mirror (for a better view of your movements)

You should also gather any extra supplies you’re using, such as:

  • Ostomy powder
  • Skin prep wipes
  • Barrier ring
  • Elastic barrier strips
  • Urostomy belt

Instructions

  1. Clean your hands.
    • If you’re using soap and water, wet your hands and apply soap. Rub your hands together thoroughly for at least 20 seconds, then rinse. Dry your hands with a disposable towel. Use that same towel to turn off the faucet.
    • If you’re using an alcohol-based hand sanitizer, cover all of your hands with it. Rub your hands together until they’re dry.
  2. Disconnect your pouch from the night bag.
    • Close the spout at the bottom of your pouch by flipping the tab so the red line is hidden. This will keep urine from running out of the pouch while you’re taking it off. The pouch is open when the red line is showing. You can remember this with the phrase “red means running.”
    • Pinch the sides of the night bag adaptor. Pull it down and away from the spout. Then, put the cap on the spout.
  3. Clean your hands. Follow the instructions in step 1.
  4. Take your pouching system off. Remove the wafer and pouch together.
    • Spray adhesive remover spray over the wafer.
    • Press down on your skin with one hand. With your other hand, gently lift an edge of the wafer and roll it away from your skin. Don’t pull the wafer straight away from your skin. The skin around your stoma is sensitive, so it’s important to be gentle. Spray more adhesive remover spray under the wafer as you go.
    • Once you’ve removed the pouching system, throw it in the trash.
    • After you remove the pouching system, hold a dry piece of gauze over your stoma opening. This will keep urine from leaking out. Change it if it gets soaked with urine.
  5. Clean and dry the skin around your stoma.
    • Moisten a piece of gauze. Use it to gently clean the skin around your stoma. Don’t use any soap.
    • Use a dry piece of gauze to dry the skin around your stoma. Make sure the area is completely dry. Your skin shouldn’t be sticky.
  6. Measure your stoma size.
    • If your stoma is round, use the measuring guide to measure your stoma. Compare the holes in the measuring guide to the size of your stoma. Choose the hole that fits comfortably around your stoma.
    • If your stoma isn’t round, measure the vertical side, then the horizontal side.
  7. Get the new pouching system ready.
    • Place the measuring guide over the back of the wafer (the side that will go against your skin). Trace the correct size onto the wafer.
    • Cut or mold the wafer to just outside of the outline. This will give your stoma extra room in case it swells a little. Check the wafer against your stoma to make sure it’s the right size.
      • If you’re using a moldable wafer, turn the wafer over so you’re looking at the front (the side that will face away from your skin). Gently roll back the opening and press down for a few seconds to keep it from rolling back too much.
      • If you’re using a cut-to-fit wafer, remember to start cutting at the center hole (see Figure 1).
    • Break the inner lining on the pouch to make room for the tubes in your stoma. You won’t need to do this once the tubes are removed.
    • Snap the low-pressure adaptor onto the wafer. Then, snap the pouch onto the adaptor (see Figure 2). Give it a small tug to make sure it’s secure.
      Figure 1. Cutting the wafer

      Figure 1. Cutting the wafer

      Figure 2. Attaching the pouch to the wafer

      Figure 2. Attaching the pouch to the wafer

    • Check the tab at the bottom to make sure the pouch is closed.
    • If you’re using a cut-to-fit wafer, peel the smaller backing from the center of the wafer. Leave the backing around the edges in place (see Figure 3).
      Figure 3. Peeling the backing from the center

      Figure 3. Peeling the backing from the center

       
    • If you’re using a moldable wafer, peel the large backing from the wafer. Leave the smaller backing around the edges in place.
    • If you’re using a barrier ring, peel the backing from both sides. Stretch the ring so it matches the size of the opening in your wafer. Press it onto the back of the wafer.
    • Set the pouching system aside with the sticky side up. Don’t take off the backing around the edges yet. If you want, you can make tabs on the backing to make it easier to remove (see Figure 3).
  8. Get the skin around your stoma ready.
    • If any urine leaked from your stoma while you were getting the pouching system ready, clean the area. Follow the instructions in step 5.
    • If the skin around your stoma is irritated or very red, put a small amount of ostomy powder onto the irritated skin. Spread the powder with your fingers. Then, dab the powder with a skin prep wipe. This will seal the powder over your skin. Let the powder dry for at least 1 minute. Fan the area to help it dry.
  9. Apply the pouching system.
    • Place the pouching system over your stoma without removing the backing around the edges. It may help to use the mirror. Make sure the wafer is against your skin at the base of your stoma. · Place your hand over the wafer for 3 to 5 minutes. The warmth of your hand will help it stick to your skin.
    • After 5 minutes, peel off the backing and press the wafer against your skin.
  10. Attach the night bag to the pouch.
    • Push the adaptor on the night bag onto the spout until you hear a click. Give it a small tug to make sure it’s attached.
    • Open the spout by turning the tab so you see the red line.
  11. Apply any accessory products you’re using.
    • If you’re using elastic barrier strips, peel the backing from the strips and place them over the wafer, close to the center. It’s okay if a small part is on your skin, but try not to have too much on your skin. This can cause irritation.
    • If you’re using a urostomy belt, attach it to the tabs on the pouching system. Hook the belt to one side of the pouching system, wrap it around your waist, then hook it to the other side. Adjust it so it fits snugly.
  12. Clean your hands. Follow the instructions in step 1.
Back to top

The Skin Around Your Stoma

While you’re changing your pouching system, look at the color of your stoma and the skin around it. Your stoma should be red or pinkish-red, like the color inside your mouth. If it’s any other color, like brown, gray, or black, tell your doctor or nurse after you finish changing your pouching system.

The skin around your stoma may be slightly pink (if you have lighter skin) or gray-brown (if you have darker skin). This is from the pressure of the wafer and doesn’t mean your skin is irritated. Your skin should go back to its normal color if you leave it uncovered for about 15 to 30 minutes.

Back to top

Caring for Irritated Skin

Irritated skin will look bright red, not pink. You may also feel burning, itching, or pain in the area. If you notice that the skin around your stoma is irritated, tell your doctor or nurse.

Back to top

Tell us what you think

Tell us what you think

Your feedback will help us improve the information we provide to patients and caregivers. We read every comment, but we’re not able to respond. If you have questions about your care, contact your healthcare provider.
 

Questions Yes Somewhat No

Last Updated