How to Change Your Urostomy Pouching System at Home

This video will show you how to change your urostomy pouching system at home.

Your pouching system includes a wafer, which is the part that sticks to your skin, and a pouch that holds your urine. You may be using either a 2-piece system, where the wafer and pouch are separate, or a 1-piece system, where the wafer and pouch are attached.

You should change your pouching system every 3 to 4 days. It's best to change it in the morning before you drink anything, when there's less urine coming from your stoma. Change your pouching system right away if it's leaking.

You can change your pouching system wherever you're most comfortable. You can do it either sitting down or standing up. Most people like to change it in the bathroom in front of the mirror.

You can also remove your pouching system and clean around your stoma as part of your shower or bath routine.

Before you start, wash your hands with soap and water or use an alcohol-based hand sanitizer. Then, gather your supplies.

You'll need adhesive-remover spray, gauze, paper towels, or a clean washcloth, a measuring guide, scissors if you're using a cut-to-fit wafer, and a new pouching system. You may also want a blow dryer or handheld fan and a small mirror.

You should also gather any extra supplies you're using, such as a thin hydrocolloid sheet, liquid skin protectant, thin barrier ring, elastic barrier strips, or urostomy belt.

First, open your pouch to let the urine run out. Make sure you do this over a toilet to catch the urine. You can put a piece of toilet paper in the toilet first to keep the urine from splashing.

Once the pouch is empty, wipe it with toilet paper and close it so no more urine runs out. Then, wash your hands.

After you empty the pouch, you can take the pouching system off. You will remove the wafer and pouch together.

The skin around your stoma is sensitive, and it's important to be gentle. Don't pull the wafer straight away from your skin.

First, spray the adhesive remover 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. Spray more adhesive-remover spray underneath as you go.

Once you've removed the pouching system, throw it in the trash.

Hold a dry piece of gauze, paper towel, or washcloth over the opening of your stoma to keep urine from leaking out. Change it if it gets soaked with urine.

If you're removing your pouching system in the shower, you don't need to do this. The urine will flow down the shower drain.

Many people enjoy leaving their skin uncovered for 15 to 30 minutes after removing the pouching system. This is called a skin break. You can decide if you want to take a skin break.

If you do take a skin break, you can hold a towel, urinal, or other container over your stoma to catch the urine that leaks out.

Next, moisten a piece of gauze, paper towel, or washcloth and use it to gently clean the skin around your stoma. Don't use any soap.

Dry the skin around your stoma. You can use a blow dryer on the cool setting or a handheld fan, or you can pat your skin dry with a dry gauze, paper towel, or clean towel.

Make sure the area is completely dry. Your skin shouldn't be sticky.

While you're doing this, 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, take a picture and send it to your doctor using your MyMSK account, and call your doctor after you finish changing the pouching system.

Your stoma will slowly get smaller over the first 6 to 8 weeks after your surgery. During this time, use a measuring guide to measure your stoma. Fit the wafer every time you change your pouching system.

Once your stoma reaches its permanent size, you can start using a pre-cut wafer. Usually, a convex or curved wafer is best.

Compare the holes in the measuring guide to the size of your stoma. Choose the hole that fits exactly around your stoma with no gaps.

Place the measuring guide over the back of the wafer. The back is the side that will go against your skin.

Use the measuring guide to mold or cut the wafer to the exact size you need. Some wafers have lines to help you. You can also trace the correct size onto the back of the wafer.

If you're using a moldable wafer, turn the wafer over so you're looking at the front. The front is 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.

Check the wafer against your stoma to make sure it's the right size. If you're using a 2-piece system, snap the wafer and pouch together.

If any urine leaked out of your stoma while you were getting the pouching system ready, clean and dry the area around your stoma the same way you did before.

Once your skin is completely dry, you're ready to put on the new pouching system. Put it on while you're sitting or standing, not lying flat.

If the skin under the wafer is irritated, apply a thin hydrocolloid protective sheet or liquid skin protectant.

If you're using a thin barrier ring, peel the backing from both sides, stretch the barrier ring to fit over your stoma, and gently press it onto your skin. It should be right against your stoma without any gaps.

Peel the backing off the wafer and place it over your stoma. It may help to use the mirror.

Make sure the wafer is against your skin at the base of your stoma. Then, place your hand over the wafer. The warmth of your hand will help it stick to your skin.

Follow the manufacturer's instructions for how long to leave your hand there. Usually, it's 5 to 10 minutes.

If you're using elastic barrier strips, peel the backing from 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.

Then, wash your hands with soap and water or use an alcohol-based hand sanitizer. You're now finished changing your urostomy pouching system.

As a reminder, the steps to changing your pouching system are: gather your supplies, empty your pouch, take the pouching system off, clean the skin around your stoma, get the new pouching system ready, and put the new pouching system on.

If you have any questions about your urostomy or urostomy pouching system, you can find more resources on our website. Go to www.mskcc.org/pe and search for urostomy. You can also ask your nurse for more information.