Ureterostomy is a diversion in the most distal place possible in
the ureter and brought out through the abdominal wall and
anastomosed to the skin. It may be unilateral or bilateral
depending upon kidney function. Ureteral stents are usually sutured
in place to maintain patency. They are often not pouched due to
proximity near the costal margin, which is not ideal for pouch
adherence. They usually have a dressing around the tube insertion
site and empty into a drainage bag or the nappy. Peristomal skin
irritation is uncommon.
Ileal conduit is when the ureters are diverted through a small
segment of the ileum (the "conduit"), which has been disconnected
from the intestinal tract, and urine is expelled from it. It is the
most common urostomy created.
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Vesicostomy is a diversion at the bladder level used to provide
temporary bladder drainage. The dome of the bladder mucosa is
sutured to the abdominal skin opening as a stoma. Urine is allowed
to empty into the nappy area. Peristomal skin irritation is
uncommon.
Family Stoma Care System Education
Points:
Adequate fluid intake is important to prevent urinary tract
infections and stone formation.
Effluent
Immediately after creation of a urinary diversion, there is a
continuous production of urine. In general, no anti-reflux
mechanism, therefore patients are at risk for urinary tract
infections. Unless there is a urinary tract infection, only minor
odour should be present. Urine may be irritating when it comes in
contact with skin. When a segment of ileum or colon is used to
construct a stoma, mucus is often expelled with urine.
