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A urostomy is an opening in the belly (abdominal wall) that’s made during surgery. It re-directs urine away from a bladder that’s diseased, has been injured, or isn't working as it should. The bladder is either bypassed or removed. (Surgery to remove the bladder is called a cystectomy.) After this surgery, urine is passed out of the body through an opening on the belly called a stoma. A Wound Ostomy Continence nurse (WOCN or WOC nurse) or the surgeon will figure out the best location for your stoma. (A WOC nurse is a specially trained registered nurse who takes care of and teaches ostomy patients. This nurse may also be called an ostomy nurse.)

The stoma will look pink to red and will be moist and shiny. The shape will be round to oval, and it will shrink over time after surgery. Some stomas may stick out a little, while others are flat against the skin.

You won’t be able to start or stop urine coming out through the stoma, so you will likely need a pouch to collect the urine as it comes out. The stoma has no nerve endings, so it’s not a source of pain or discomfort. It is just a change in the way urine comes out of your body.

A urostomy is not a disease, but it's usually needed because of a disease or other problem. A urostomy causes a change in the way your body works. It surgically changes the way urine comes out of your body.

Why would you need a urostomy?

Urostomy surgery is done when certain diseases and conditions cause serious bladder problems.

If there’s cancer in the bladder, part of the treatment may be to remove all or part of the bladder and divert or detour the urine by doing a urostomy.

Some people find it easier to manage a urostomy than a defective bladder. Bladder problems often mean that people can’t control the flow of urine – they are incontinent. This can be stressful, and the constant wetting may cause skin problems.

Some children are born with a defect in the urinary tract that causes urine to back up into the kidneys. This leads to chronic or repeat infections. For these children, a urostomy may be life-saving. Surgery can make a pathway through which the urine may travel easily, without any blockages (or obstructions) that cause it to back up. This allows the kidneys to work their best.

Getting ready for surgery

As you get ready for abdominal surgery, your doctor and/or ostomy nurse will explain the process and look at your abdomen to find the best location for the stoma. You may be asked to wear a sample pouch to make sure that the place chosen is on the flattest possible surface and that you are comfortable in all positions. If you have any hobbies, activities, or habits that might be affected by where the pouch is placed, talk to the doctor or the ostomy nurse.

Talking with someone who has gone through the same experience can help, too. Look for an ostomy visitor program in your area - an ostomy nurse can help with this. This is a program that matches you with a volunteer from the United Ostomy Association of America who has a urostomy and has adapted well to the changes that it brings. They can answer many of your questions about day-to-day life. You may also find it helpful to take part in an ostomy support group. A support group allows you to share your feelings and ask questions as you recover and adjust to your urostomy. You can also share your story with others who may be helped by your experience.