Urostomy Care Guidelines

Optimal Changing Schedule

• The American Cancer Society recommends changing urostomy bags every 5-7 days to prevent complications while minimizing unnecessary handling 1
• More frequent changes may be necessary in cases of leakage around the stoma, as recommended by the Clinical Gastroenterology and Hepatology society 2

Proper Changing Technique

• The British Journal of Dermatology suggests handling the skin carefully to minimize trauma and reduce the risk of complications 3
• The Clinical Nutrition society recommends cleaning the peristomal skin with fresh tap water and mild soap, then thoroughly drying before applying a new appliance 4
• The Clinical Gastroenterology and Hepatology society advises ensuring the opening of the appliance is cut approximately 1/8 inch larger than the stoma to prevent irritation while limiting skin exposure to urine 2
• The British Journal of Dermatology recommends avoiding using adhesive tapes directly on sensitive skin; consider soft silicone tapes for securing essential items 3

Preventing Leakage and Skin Complications

• The Clinical Gastroenterology and Hepatology society suggests measuring the stoma size at each appliance change for the first 8 weeks as the stoma may change in size during this period 2
• The Clinical Gastroenterology and Hepatology society recommends using barrier films or creams containing zinc oxide to protect the peristomal skin from urine exposure 2
• The Clinical Gastroenterology and Hepatology society advises considering convex appliances, ostomy belts, paste, or barrier rings for stomas that are flush with the skin or positioned in difficult locations 2
• The Clinical Nutrition society suggests that for persistent leakage issues, foam dressings rather than gauze can help reduce skin maceration by lifting drainage away from the skin 5

Managing Peristomal Skin Problems

• The British Journal of Dermatology recommends cleaning any signs of infection promptly and considering topical antimicrobial agents if necessary 3
• The Clinical Nutrition society suggests that for excessive granulation tissue around the stoma, consider application of a foam or silver dressing over the affected area 5

Common Pitfalls to Avoid

• The Clinical Gastroenterology and Hepatology society warns that not changing the bag frequently enough can result in leakage and skin breakdown 2
• The British Journal of Dermatology advises using adhesive removers properly to avoid damaging sensitive peristomal skin 3
• The Clinical Gastroenterology and Hepatology society recommends properly measuring the stoma before cutting the appliance opening to prevent exposure of peristomal skin to urine 2