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What Is a Urostomy?
An ostomy is a surgically created opening
in the abdomen for the discharge of body
waste. Ostomies that discharge urine are
urostomies. After the ostomy is created, your
child will release urine through a stoma.

The stoma is the end of the small or large

intestine that can be seen protruding or
sticking out of the abdominal wall. It is the new
site where urine will leave the body and be
collected in the ostomy pouch. The size and
location of the stoma depend on the specific
operation and the shape of the abdomen.

Most stomas are similar and will:

ff Stick out of the body, usually an
inch or less above the skin

Your Child’s Urostomy

ff Vary in size

ff Be round or oval in shape

ff Be red and moist (similar to the inside of your mouth)

ff Have no feeling

ff Be slightly swollen for the first weeks after the operation

and then shrink to their permanent size

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Urostomy
Understanding Your Child’s Urinary System
The urinary system includes two
kidneys, two ureters, a bladder, and
a urethra. The kidneys make urine by
filtering water and waste products
from the bloodstream. The urine
drains from the kidneys, through the
ureters, and empties into the bladder.
The bladder stores the urine. Urine is
expelled or comes out when it passes
from the bladder through the urethra.
The creation of a urostomy changes
how urine is emptied from the body.
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The Operation
A urostomy is an operation that reroutes
urine to an opening on the surface of
the abdomen. A common urostomy
Kidney
operation involves removing a small
section of the ileum (small intestine).
The intestine is reconnected so that it
functions normally. The surgeon uses the Stoma
Ureters
small piece of ileum that is removed to
Ileal Conduit
make a detour for urine, which is called
an ileal conduit. One end of the piece is
sewn closed, and the other end is brought Bladder
to the surface of the abdomen to form a
stoma. The ureters are removed from the
bladder and attached to the new ileal conduit. Urine now flows from the kidneys, through
the ureters, out the ileal stoma, and into the collection pouch. The surgeon can also perform
the operation using a section of the colon (large intestine), which is called a colon conduit.

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Urostomy Output
Urine will start flowing into the ostomy pouch right
after the operation. It may be pink or red for a few
days before returning to the normal yellow color.
Because the urine is passing through a segment
of the intestine and the intestine produces mucus,
you may see some mucus in your child’s urine.

Stent

Urostomy Stents
Due to postoperative swelling, your child may have small temporary tubes
called stents extending out of the stoma. Stents are placed up the ureters
and help keep them open. This allows urine to drain through the stoma. They
will be removed by the surgeon or nurse once the swelling decreases.

About the Pouch

Your Child’s Urostomy

The urine will now exit from a new opening called a stoma and be collected in a pouch.
Your child will not be able to feel or control the urine as it leaves the body through
the stoma. He or she will need to wear an ostomy pouching system at all times.

The pouching system sticks or adheres to the skin around the stoma.
The pouch:

ff Collects urine
ff Contains the odor
ff Protects the skin around the stoma

Urine on the stoma will not cause any problems. Urine on the skin
surrounding the stoma can cause the skin to get red or irritated.

Ostomy pouching systems are lightweight and lie flat against the body.
Pouching systems come in different sizes and styles. Your doctor or certified
ostomy nurse can help you choose which one is best for your child. Most
people try several types of pouches to find one that works well for them.

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Pouching System/Types
Pouch systems are made up of the skin barrier that holds the pouch to the skin and the
pouch that collects the drainage. They are available as a one-piece or a two-piece system.

ONE-PIECE SYSTEM
In a one-piece pouch, the pouch and skin
barrier are attached together.

T WO -PIECE SYSTEM
In a two-piece system, there
is a skin barrier and a separate
attachable pouch. The skin barrier sticks to the skin around
the stoma and protects the skin, giving you a place to
Your Child’s Urostomy

attach the pouch. The skin barrier usually includes a flange

or rim that is used to seal the pouch to the skin barrier.
Flange sizes are made to fit exactly to a specific pouch.

UROSTOMY POUCH
All urostomy pouches are drainable and
have a special valve inside the pouch
that prevents the urine from backing up
around the stoma. The drain expels urine
at the bottom of the pouch. The drain
can be a tap that turns to open or close,
or a drainage nozzle that has a plug.

Many pouch taps have a colored

marking to indicate when the pouch is
open. The mark cannot be seen when
the tap is closed. You do not need
to remove the drainable pouch to
empty it. It can remain in place for several days.

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Color
Some pouches are clear or transparent, and others are opaque (one can’t see through
them). While in the hospital, the pouch will most likely be clear or transparent.
When your child goes home, you may prefer to switch to an opaque pouch.

Pouch Size
Pouches can be small or large. The size that your child needs depends on the amount

Your Child’s Urostomy

of urine produced. A urostomy produces liquid output and needs to be emptied about
five times a day, so a larger pouch may be needed. Other types of pouches are also
available for specific needs. If your child uses a wheelchair and has trouble emptying the
pouch into the toilet, or if he or she tends to toss and turn a lot at night, a mini pouch
connected to a drainage bag is also an option. For short bouts of swimming or exercise,
a urinary stoma cap is available—which is a mini pouch filled with absorbent material.

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Pouch Belts and Wraps

Some children wear an ostomy belt or wrap around their abdomen
for added security or to help keep the pouch on during activity.
Wearing a belt may be a personal choice, or the ostomy nurse
may recommend wearing one if your child is having difficulty
keeping the pouch on. If your child wears an ostomy belt:

ff Attach the belt so that it lies evenly

against your child’s abdomen and
lies level with the pouching system.

ff The belt/wrap should not be so

tight that it cuts into or leaves a
deep groove in your child’s skin.

ff You should be able to place

one finger between the belt
and your child’s abdomen.
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Pouch Covers
Pouch covers are lightweight, soft coverings that go
over the pouch. They come in a variety of colors and
prints. The coverings may decrease any uneasiness
associated with having someone see the pouch.

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Daily Care
During the day, the urostomy pouch will need to be drained about
every 2 to 4 hours. It will need to be drained more often if your child
drinks a large amount of fluids. Get recommendations from your child’s
doctor about how much fluid your child should be drinking.

Nighttime Drainage
All urostomy pouches come with adapters that can be attached to a larger
drainage bag that keeps the pouch empty while your child is sleeping.

Connecting to the drainage bag:

ff Place the adapter on the nighttime drainage bag.

ff Connect the end of the pouch to the connector Pouch

of the long tubing on the drainage bag.

ff Open the pouch tap.

ff Unravel and free the long tubing from any kinks.

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ff Drainage bags can be freestanding or
hooked to the side of your child’s bed

Disconnecting and emptying the drainage bag: Adapter

ff Remove the drainage bag tubing from the pouch.

ff Close the pouch.

ff Empty the urine from the drainage bag into the toilet.

ff You may be instructed to rinse the drainage

bag with water or water and vinegar to
decrease odor. Other bag-cleaning products
may be suggested by your nurse or doctor.

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Your Child’s Urostomy

American College of Surgeons • Division of Education