Tips for Changing a Urostomy Pouch with Continuous Output

This is my first post even though I have had a colostomy and urostomy for about four years now, and I get on okay in general. However, having recently read how important it is to keep hydrated, I am hoping someone with a similar problem might be able to offer advice.

The problem is finding the best time to change my urostomy pouch, as it seemingly never stops outputting long enough to clean up and get the new pouch in place. Urine trickles out every few seconds, so there is not enough time to switch pouches, even if I remove the old one, spray to remove the old adhesive, and clean around the area—all with a dry wipe in place to catch the continuing output. Then, at the right moment, I quickly place the new pouch and press all around to fix it in place.

The only method that I have found to work is to stop taking fluids in the morning and go without any fluid intake all day, making the change in the evening, by which time the frequency of output has dropped to a trickle every ten or twenty seconds, which gives me time to do the switch. As soon as I have finished, I have plenty to drink and return to normal fluid consumption, but reading several posts here, I can see that it is important to keep hydrated, which of course I do at every other time.

I would be really interested to hear if anyone else has this problem, and if so, what method they use to overcome what is really quite a harrowing experience every time. It tempts me to leave off changing the pouch for longer periods than is recommended by the stoma nurses, usually four or five days. I use a Hollister one-piece with the usual tap and viewing option.

Thanks, everyone.

I feel your pain! I have the same problem.

I have not gone to your extreme of not drinking all day, though. The best time for me is first thing in the morning before coffee, but it still trickles out. 🤬

Picking a time is further complicated by wanting to do my colostomy at the same time. So I pick a time when both outputs are low. For me, that is usually around noon before I eat lunch. Coffee has processed through, and I usually haven't started my water yet.

I place a towel on my lap to catch sudden large streams and use a paper towel to catch output while I clean and dry the skin. I always use a barrier wipe on that side. Then it's all about my luck. I try to slap on the wafer before output needs to be cleaned again.

The trick is the barrier wipe protects my skin, so I just dry any dribbles without starting over with cleaning the skin. I think that's fine for a few drops. If I get a stream of urine on the skin, I usually clean the skin again.

There's a device called a stoma genie. It's basically a cardboard tube with absorbent material inside. It's very clever and works well enough. I found it hard to hold flush against my skin; I kept tilting it. That might be a me problem. My other issue is they don't make a size that fits my stoma, so I cannot slide the wafer over the tube. Therefore, I still need to get lucky placing the wafer. You might find it more useful than I did, and it's probably worth a try.

Thank you, SusanT.

Initially, I thought the StomaGenie was the answer, but at the moment, I use a one-piece urostomy pouch, and of course, this device can only be used with a two-piece system; otherwise, you wouldn't be able to pass the baseplate down the length of the device. Such a pity; I thought you had solved my problem!

One-piece pouches are more prevalent here in the UK, and that is what I have been prescribed; however, I will have a chat with my stoma nurses and see what they think, and whether they have any ideas, or perhaps I could get them to look into changing my prescription.

As far as I could tell, the StomaGenie isn't available from Amazon.co.uk, and I could only find it on Amazon.com, and the StomaGenie website only talks about Medicare and healthcare in the USA. There may be a UK equivalent, and I will make the appropriate inquiries and hopefully make progress toward a solution and some relief from my dehydration regime.

Meanwhile, thank you so much for your help, and if I get anywhere, I'll stick a comment on here in case it helps anyone else.

G-Day nokey,

I have an ileostomy, so please ignore my ignorance of urostomies, but I am a mad inventor, and my mind instantly said a plug.

Let's say you go for a two-piece, which I think would be better for you, and then try to find something with a slight taper around the size of the outlet of the stoma. After seeing that it is very clean, push it into the opening, stopping the flow long enough to do the job.

Susan, are you still there? Would this be possible????

If it works, ileostomies and colostomies could try it.

Regards, IGGIE

I would not risk a plug. All you have in there are the ends of the ureters from each kidney, and they do not expand and contract like a colon or small intestine might. Best case, the urine backs up in the kidneys, which risks kidney damage. Worst case, the plug damages the ends of the ureters or disrupts the stitching holding the ureters in place.

For context, the ER nurse was hesitant to catheterize me through the stoma for fear of damaging it, and my urologist inserted a nephrostomy tube rather than risk putting in a stent through my stoma. The nurse in the urologist's office was comfortable inserting a catheter to get a urine sample, but it seems like a specialized skill that not every nurse has. My overall impression is that the urostomy stoma is more delicate than a colostomy or ileostomy stoma. I wouldn't mess with it.

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Thank you for that information, Susan. It was just a thought.

IGGIE

It was a good thought for ileostomies and colostomies. I was worried that someone else would try it for a urostomy, so I wanted to give a detailed explanation.

Thank you both; I do find my urostomy is very delicate and bleeds with any contact other than the gentlest of wiping. I am sure a colostomy would be more resilient, though, but of course there isn't the uncertainty of sudden output as there is with a dripping urostomy. I will most certainly consult with my local stoma center nurses and ask if anyone else has my problem. I don't like the idea of dehydration for several hours, and I'm sure they wouldn't recommend it, but I have to do something about it. Thank you IGGY and SusanT.