This topic is about a person who has survived stage 4 rectal cancer and is now facing a new challenge. Due to damage from radiotherapy, her bladder no longer functions, and she currently manages this with self-catheterization and large incontinence pads. Her surgeons have suggested a rare procedure called a "double barrel wet colostomy." This involves creating a small opening for the ureters just below her existing colostomy, allowing both urine and stool to drain into the same appliance. With fewer than 20 of these procedures performed in the UK, she is seeking advice and experiences from others who might have undergone this surgery.

Here are some insights and advice shared by others:

1. Confidence in the surgical team is important. Trusting the specialists who recommend this procedure can be reassuring, as it seems to be the simplest solution for managing both fecal and urinary diversion in her case.

2. Exploring alternatives might be worthwhile. Some suggest considering a separate urostomy, which would involve managing two bags, as others have successfully adapted to living with dual stomas.

3. Seeking additional opinions and connections can provide more clarity. It might be helpful to ask the surgeon to connect her with previous patients who have had a wet colostomy or with clinicians experienced in the procedure. Ensuring that all possible options, like a continent catheterizable channel or a urostomy, have been discussed is also recommended.

4. Educational resources can be valuable. The Memorial Sloan Kettering Cancer Center offers a patient guide titled "Caring for Your Wet Colostomy," which covers daily care, appliance fitting, and long-term outcomes. They might also provide expert advice remotely. Additionally, a PubMed article on wet colostomy outcomes and techniques could offer clinical data to inform discussions with the surgical team.

5. Perspective on reported mortality is important. It's noted that the earlier group of patients may have been older or had other serious health issues, so the mortality data should be viewed in context rather than as a direct risk indicator for her situation.

6. Appliance considerations are crucial. Although no specific pouching system exists for this type of stoma, experienced ostomy nurses can customize solutions. This might include cutting larger openings, using extended-wear barriers, or applying seal rings to protect the adhesive from urine, which can help minimize leaks.