Urostomy bags are worn by those who have undergone surgery result in a urinary stoma – a urostomy (sometimes known as an ileal conduit). There is an array of different types of urostomy bags available, and your Stoma Care Nurse will help guide you as to which one you feel is most comfortable and aesthetically pleasing.
You may find that immediately after surgery you are fitted with a larger bag to collect the urine and of clear material, so the nurses can monitor your output without disturbing the bag. Further down the line when you are fully recovered and back home you may decide to change to a different style of bag, but which one? Hopefully this information will help you understand why there are different types of urostomy bags available, and which one might suit you best.
What are the different types of urostomy bags available?
Most urostomy bags come as a 1- piece pouch or a 2-piece pouch system. Different pouching systems are made to last different lengths of time. Depending on the type of bag you use, it may be changed daily.
A 1 -piece system is made up of a bag which has an adhesive layer. This adhesive layer has a hole (aperture) in the centre which fits over your urostomy and the adhesive layer then sticks to your skin around your stoma. The whole system is removed as 1 piece.
A 2-piece system has a skin barrier called a flange or baseplate. The flange is the part with the hole in the centre which fits directly over your urostomy and sticks to the surrounding skin. The flange can remain in place, on your skin for up to 2-5 days. The bag is separate and is applied on top of the flange and therefore can be changed separately without disturbing the flange or skin.
Both types of bag systems come with:
- Both cut-to-fit and pre-cut holes, in various sizes to fit different types of stomas
- A slightly thicker flange as urine can be corrosive to the adhesive and your skin, therefore the flange will help protect it
- The sizes of the bags are available in mini, standard, maxi or paediatric
- All bags are waterproof, odour proof and have a skin friendly adhesive which acts as a protective barrier to your skin.
- Some bags have a split fabric cover, which can help with positioning and the contents can be viewed
- The urostomy bags have a non-return valve which prevent the urine in the bag from flowing back over the stoma.
- The bags have taps or bungs at the end to enable the person to drain the urine down the toilet.
Night bags – a larger bag which is attached onto the end of the urostomy bag, can provide continuous drainage overnight. This can help you have an undisturbed night without the worry of having to get up to empty your urostomy pouch. Night bags and leg bags tend to be a personal preference and are certainly not compulsory, some people prefer to get up during the night to empty their pouch whilst others prefer not to. Find what works best for you and your personal situation.
If you do choose to use a night bag, check whether your night bags fit your urostomy bag directly, as some will need a connector or adaptor to link up the urostomy pouch to the night bag. These can be ordered with the rest of your urostomy supplies or may already be in the boxes with your urostomy bags.
Check the type of night bag you are using as some are single use only and can be drained each morning and disposed of, whereas others are re-usable and will need to be washed out with warm soapy water and left to hang/dry in your bathroom before re-using the next night. It is a good idea to throw these away every 5-7days and use a new night bag, to prevent any bacteria growing in the tubing which may travel and cause a urinary infection.
When to empty a urostomy bag?
Empty the bag often, usually when it is one third to one half full. A urostomy bag will hold the same amount of urine as your bladder did, so you will only need to empty it the same number of times you used to urinate before your illness or surgery!
When to change a urostomy bag?
Many people find that they need/want to change their 1-piece pouch system every day or every second day. This will be dependent on how well the bag adheres to your skin, whether you experience any leaks and how active you are. Some people find that using a seal or washer around their stoma gives their bag a longer wear time, as urine can be corrosive to the skin barriers for some. When to change your bag is down to personal preference, but most 1-piece systems do not last much longer that three days before starting to cause issues with leaks, which can lead to sore skin.
Those who are using a 2-piece pouch system may find they get slightly more wear time out of their bags as the flanges can be a little bit thicker. The flange can be left in place for a few days, cleaned and another bag maybe re-applied. Again, it is finding what suits your needs and what works best for you.
Make sure you are checking your skin regularly when you are changing your 1-piece and 2-piece system and watch out for any moist, sore or reddened skin, this will guide you as to whether you need to change your pouch more often.
Caring for your stoma
The stoma itself should be red in colour and feel moist to the touch. The section of bowel used to create the urostomy will produce mucus to help keep the tissues healthy, therefore your new stoma will produce mucus which resembles a white-jelly like substance. The amount varies from person to person but should slowly reduce over time.
The stoma does not have any sensory nerve endings and therefore has very little sensation, it does not cause any pain to touch but may be a little tender around the edges initially. It is very vascular with a rich blood supply and may bleed readily whilst it is being cleaned. A few spots of blood when you clean your stoma is nothing to be concerned about and it simply reminds you to go gently.
- Wash the stoma and surrounding skin with warm water before applying your next stoma pouch.
- Try to avoid using soaps or any fragranced body washes
- Take the time to check your stoma and the surrounding skin for any irritation
- Gently dab the skin and stoma dry before applying your next pouch
Your stoma will slowly reduce in shape and size during the first 6-8weeks following surgery. Your stoma care nurse will help guide you in measuring your stoma and getting the correct fitting and aperture size for your stoma pouch. Further down the line, if you lose or gain weight, your stoma may change shape or size, again it is worth checking the fitting of your stoma appliance is good.