Changing Your Two-Piece Disposable Urostomy Appliance

This information will help you care for your two-piece disposable urostomy appliance.

Changing Your Appliance

  1. Organize and set out your supplies. You will need:
    • Warm water
    • Unsterile 4x4 gauze
    • Measuring guide
    • New wafer
    • New pouch
    • Scissors (if you have a standard wafer)
    • A pen (if you have a standard wafer)
    • A mirror (if you wish to look at your movements during this process)
  2. Open the closure at the bottom of your old pouch and empty any urine from the pouch.
  3. Gently remove the old wafer with the pouch attached. If the old wafer is hard to remove, use adhesive remover (spray or wipe) or warm water on a gauze to help break the sticky seal as you gently pull off the wafer.
  4. Place a gauze directly over your stoma opening. This will prevent urine from leaking while you are changing the pouch. Change the gauze as it becomes soaked with urine.
  5. Measure your stoma size using the guide or the template made for you. Measure the vertical, then the horizontal, allowing a one-eighth inch border around the edges of your stoma. You will need to measure your stoma for about 6 to 8 weeks because it will gradually shrink. After this time you can buy the wafers precut or prepare them in advance. Some companies will charge extra to precut. You can buy your own cutter instead.
  6. Trace the outline of the opening on the paper backing of the wafer.
  7. Cut out the pattern on the new wafer (see Figure 1). If you wish, snap the wafer and pouch together. If you have a moldable wafer, mold it to the exact size of your stoma; there should be no gaps. Do not cut a moldable wafer.
    Figure 1.
  8. Remove the backing on the new wafer (see Figure 2). Set the wafer aside with the sticky side up.
    Figure 2. Removing the backing
  9. Clean the skin around your stoma with warm water.
  10. Dry your skin thoroughly. If your skin around the stoma is irritated, see the section “Caring for Irritated Skin.”
  11. Fan the area dry or use a blow dryer on a cool setting until it is completely dry. Your skin should not be sticky.
  12. Center the wafer around your stoma and apply it. Press the new wafer firmly to your skin, paying particular attention to sealing the area directly around the stoma (see Figure 3). If urine leaks on your skin before the new wafer is in place, you must clean your skin again by following steps 9 through 11.
    Figure 3. Press the wafer firmly
  13. Secure the bottom closure of the pouch.
  14. Attach the pouch to the plastic rim on the wafer if you haven’t already (see Figure 4). Align the plastic rim of the wafer. Starting at the bottom of the rim, gently apply pressure around the rim. You will hear and feel several snaps when the pouch is secure on the rim. Hold the wafer with 1 hand and gently tug on the pouch to make sure it is snapped securely.
    Figure 4. Attach the pouch
  15. Lift the pouch on the left and right sides and underneath to check for any wetness or leaking.
  16. Change the pouch and wafer every 4 days.
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Caring for Irritated Skin

  1. Measure the size of your stoma again. Use the measuring guide or the template that was made for you. Remember to allow only a one-eighth inch border around the edge of the stoma, so measure the vertical then the horizontal. Adjust the size of the opening if needed.
  2. Apply a thin layer of Stomahesive® powder to your irritated skin. Dust off the extra powder by brushing lightly with a gauze pad. This is called “crusting.”
  3. Pat the area with No Sting Skin Barrier® and allow it to dry. Fanning with a 4x4 gauze is effective.
  4. Apply the pouch as above.
  5. If your skin has not healed in 1 week, contact your Wound, Ostomy and Continence Nurse (CWOCN) or your doctor.
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You may shower daily with the pouch and wafer in place, however do not use perfumed or oil-based soaps around your stoma. Ask your CWOCN for tips about using shower protectors. If you use Brava Elastic Barrier Strips™, change them on day 4 when you change your pouch. Some people have found that using Glad Press’n Seal® wrap can help protect the tape border of the wafer.

On the day you change your pouch you may remove your wafer and pouch before you shower. Urine will continue to flow from your urostomy while you shower.

You can use a stoma cup and a belt while you’re drying off. After you dry off, apply a fresh wafer and pouch.

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Home Care of Your Night Drainage Equipment

  1. Tape the connections between the pouch and night drainage bag, if you wish. Use a leg stabilizer if you move around a lot while you sleep.
  2. Each morning, empty the urine from the drainage bag. Wash the drainage bag and tubing with lukewarm water and liquid soap.
  3. Rinse the drainage bag and tubing with a solution of 1 part white vinegar and 3 parts water. Allow the bag and tubing to air dry.
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Ordering Supplies

Order your supplies when you have only 1 box of pouches left. You can get more through your local surgical supply store. You can get them from a distributor such as Edgepark 800-321-0591, Byram 877-902-9726, Liberty 800-357-4619 or CCS Medical 888-724-4357. You can also contact the surgical supply company at the number on your urostomy kit.

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Emergency Kit

  • Have a set of your ostomy equipment with you at all times in case your pouch leaks.
  • Carry a small case with a precut wafer and pouch and several gauze pads.
  • Protect your ostomy equipment from direct sunlight or heat.
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Your travel decisions should not be based on the fact that you have a stoma. The following hints should help make your travel experience worry-free.

  • Take extra supplies in case you have trouble getting them where you are going.
  • Carry all your equipment with you. Do not check it on the plane or train. There is always the chance you may become separated from your luggage.
  • Avoid driving a car for 4 to 6 weeks unless your doctor tells you otherwise. You may wear a seat belt loosely or place a small pillow over your stoma and under your seat belt. There is also the Freedom Belt® for ostomates. Check with your distributor or ask your nurse about the belt.
  • You can use a leg bag if you will be delayed getting to a toilet when the pouch is one-third of the way full.
  • If you’re traveling by airplane, you may obtain a travel card from the United Ostomy Associations of America. They can be reached online at or by calling 800-826-0826.
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