Urostomy, its Types, and Pouching System
When a patient goes through the bladder or kidney disease, doctors have to perform urostomy to change the pathway of urine discharge. An opening created on the outside of the abdomen called stoma for the collection of urine. The exact name of the surgery depends on the diversion and re-routing of the tract.
Types of the Urostomies
There are two options for the urostomy:
Incontinent diversion.
Continent diversion.
Incontinent Diversion
The incontinent diversion has also named as standard or conventional urostomy. When a person has bladder cancer, neurological dysfunction, birth defect, or chronic inflammation of the bladder, then surgeons can suggest conventional diversion. In this operation, an ileal conduit has made. It is a small pouch that can collect the urine. Doctors made this through a small part of the intestine (bowel).
In this surgery, surgeons have to cut a six to eight inches piece of the lower part of the ileum and attach it to the colon (a part of the large intestine). The remaining part of the small intestine connects to the large intestine. They remove or detach the ureters from the bladder. Finally, doctors attach the bladder as the replacement of the removed ileum. The end part of the ileum brought to the front part of the abdomen or the opening called a stoma. Urine collects into the pouch, attached to the stoma opening. A urostomy patient should wear a drainable bag. Moreover, he should clean and empty it frequently. As it is an uncontrollable process. A patient cannot control the output or discharge. So, it is better to wear a drainable appliance and empty it on time.
Continent Diversion
The continent diversion also called a continent urostomy or continent urinary reservoir. In this surgery, doctors create an internal pouch in a patient. Surgeons made this pouch so that it can control the backing up of the urine from ureters to the kidneys through valves. There is another valve in the bag to keep the urine in it until it has removed. A patient should drain and empty the pouch five to six times a day. Well, it depends on the frequency of urine discharge. A patient may have to drain it more than six times a day. A patient’s nurse can teach you how to drain with a thin tube, called a catheter. Moreover, the emptying and cleaning timing of an ostomy bag depends on the patient’s condition.
Types of Continent Diversion
The following are the few types of continent diversion or continent urinary reservoir.
Kock pouch.
Indiana pouch.
Mitrofanoff procedure.
Ileal neobladder.
Types of Pouching System
Ostomy pouches or bags have several types, styles, sizes, and shapes. Everyone’s stoma’s size and shape are different. Therefore, there are many kinds according to the need of a patient. Moreover, they have created according to the lifestyle of a person. If a person is a player or swimmer, there is a special belt for the ostomates to secure their bag, its position, and control the leakage. However, every type has a barrier, flange or wafer, and adhesive.
There are two main types of pouching system:
One-piece pouching system.
Two-piece pouching system.
One-piece Pouching System
In this type, the skin barrier has attached to the main pouch. Both are inseparable. Once a patient removes the pouch, the barrier or wafer comes off with it.
Two-piece Pouching System
In a two-piece pouching system, there is a separable skin barrier and pouch. You can pull out the bag without removing the skin wafer. It can stay and attach to the peristomal until you remove it.
When a patient is in hospital, his/her nurse guides and teaches all about the ostomy appliances and their usage. Therefore, you should discuss your convenience and learn about all the types, kinds, and styles.
