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A urostomy may seem daunting because of perceptions on how it changes one’s lifestyle, but proper management can go a long way to helping people live fruitful lives with a stoma. If you are scheduled to undergo a urostomy soon but are not sure what it entails, this guide should help clarify your doubts and concerns. What is a Urostomy? A urostomy is a type of ostomy surgery in which an opening (called a stoma) is temporarily or permanently created in your abdomen to allow your body to remove urine. It is typically performed when the urinary tract cannot function properly, often due to a medical condition that requires removal of parts of the urinary system (such as the bladder). A urostomy diverts urine to be excreted through the stoma instead of through the urinary tract. A small segment of the small intestine (the ileum) is used to create a tube connecting the stoma to the ureters. The procedure will also involve carefully separating the functional parts of your digestive or urinary tract from the problematic parts. The excreted waste is then collected in a bag or pouch attached to the stoma. Living with a urostomy takes time to get used to, but once you become familiar with the proper care of your stoma, it will barely interfere with your usual daily routine. Types of Urostomies There are two primary types of urostomy procedures: incontinent and continent urostomies. Incontinent Urostomy An ileostomy diverts a part of the small intestine (ileum) to the abdominal wall as a stoma. Because the output tends to be more liquid-like, ileostomy bags are primarily designed to hold larger volumes of semi-solid or liquid output. An ileostomy bag is made of a soft, flexible, and durable material that helps prevent leaks over long periods, while the adhesive seal connecting the stoma to the wafer is also stronger, providing more secure bag placement and handling. High-output ileostomy bags are also available, allowing people with high-output stomas to have more peace of mind on busy days. Continent Urostomy A continent urostomy involves creating a new bladder-like pouch using a portion of your small or large intestine to hold urine without needing an external appliance. The urine is removed either by emptying into the urethra and being expelled as usual, or by a catheterising pouch that allows regular drainage via a catheter. Why Would You Need a Urostomy? Your urinary system comprises both kidneys, a pair of ureters that connect the kidneys to the bladder, and a urethra that expels the urine. The kidneys produce urine by filtering water and waste products from your bloodstream, then draining it through the ureters into the bladder. Urine is subsequently removed from the body through the urethra. When any part of the urinary system fails for various reasons (such as bladder cancer), a urostomy allows urine to be diverted from the urinary system and drained through the stoma. In doing so, it prevents urine from accumulating in the body, which could cause further (and more chronic) health complications. Some of the more common reasons a person may need a urostomy include: Bladder cancer Trauma to the bladder or urethra Urinary incontinence Nerve damage affecting bladder control Other spinal injuries or conditions Urinary abnormalities What to Expect After a Urostomy A urostomy is an involved surgical procedure that may require the removal of part or all of your bladder (or other parts of the urinary system). Urine may start flowing from the stoma a few days after surgery and may initially appear slightly pink or red. It should not be long before urine returns to its usual colour. Since the small intestine produces mucous as part of its digestive role, you may notice some mucous in your urine while excreting it. Once you begin the recovery phase, not long after surgery, your stoma care nurse or doctor will teach you how to use your ostomy pouch and care for your stoma. Stoma Care A healthy stoma should appear moist and reddish or pinkish, protruding from your lower abdomen. The stoma may initially appear swollen after surgery, but it will gradually shrink after several weeks. You may notice some bleeding when cleaning your stoma, but it should subside over time. When the output first comes out of the stoma, it will be strong-smelling and watery. This is normal, as your bowels have not been functioning properly since the surgery, so the output’s appearance will gradually normalise once you begin taking a balanced diet per your doctor’s instructions. Note that it may take some time before you can eat and drink as usual. To care for your stoma, be sure to follow these instructions: Wash your hands with soap and water before checking your stoma. Check your stoma often to detect and treat problems early. Gently clean the stoma to prevent excessive bleeding. Avoid applying any oils, creams, or powders around the stoma. Regularly shave the hair around your stoma to prevent inflammation of the hair follicles. Ensure the skin barrier is cut to fit your stoma properly, with no gaps that could cause a leak. Ensure the stoma area is dry before applying the urostomy pouch’s skin barrier. If you experience irritation or other issues around the stoma area, remove the urostomy pouch and look for signs of a leak. Clean the stoma area thoroughly and replace the urostomy bag. Urostomy Pouch Urostomy pouches are waterproof and odour-proof, preventing leakage of stoma output for several hours. These pouches are available as part of one-piece or two-piece systems: one-piece systems combine the pouch and skin barrier, while two-piece systems feature a skin barrier and a separate attachable pouch. One-piece systems are generally more convenient to use, while two-piece systems are more versatile and reduce skin irritation from frequent skin barrier changes. You will still need to change the pouch regularly to maintain your hygiene and prevent complications. Your choice of urostomy pouch will largely depend on the size and shape of your stoma, so

For those who have an ostomy, the stoma opening marks a significant change in their lifestyle. There are different types of ostomies, and each may require a specific stoma bag to manage the bodily waste excreted from the stoma. How do you know whether to use a urostomy, ileostomy, or colostomy bag? What is an Ostomy Bag? An ostomy bag is a medical appliance with an inner waterproof and odour-proof layer that allows it to retain waste matter excreted from your stoma. It features a skin barrier (or wafer/flange) that adheres to the skin around the stoma and protects it from potential leaks that could cause skin irritation or other issues. The waste collects into the bag for disposal, and some bags may feature a viewing port so you can check their contents. Ostomy bags are available in various forms and must be replaced periodically. The type of ostomy surgery you undergo will also influence the ostomy bag you use, including how frequently you must change it, which activities you should limit, and more. It can take some time to adjust to life using one throughout your daily activities, but with the support of a stoma care nurse and doctor, you will gradually become familiar with handling your ostomy bag. Key Differences Between Ostomy Bags There are three different types of ostomy procedures, each of which uses a different part of your digestive tract as a stoma. What is an Ileostomy Bag? An ileostomy diverts a part of the small intestine (ileum) to the abdominal wall as a stoma. Because the output tends to be more liquid-like, ileostomy bags are primarily designed to hold larger volumes of semi-solid or liquid output. An ileostomy bag is made of a soft, flexible, and durable material that helps prevent leaks over long periods, while the adhesive seal connecting the stoma to the wafer is also stronger, providing more secure bag placement and handling. High-output ileostomy bags are also available, allowing people with high-output stomas to have more peace of mind on busy days. What is a Colostomy Bag? A colostomy involves creating a stoma from part of the large intestine (colon). The output from a colostomy is generally thicker and more formed compared to an ileostomy, as the colon is responsible for processing food waste into faecal matter for excretion. A colostomy bag is either a single-use closed bag or a drainable one for softer, semi-solid stools. Stool consistency may change over time after your colostomy procedure, influenced by your colostomy type, emotional state, dietary adjustments, and medications you take. Regardless, bags should be emptied several times a day once they are full, depending on bowel movement frequency and the type of bag used. Odours are mostly present if there is a leak, necessitating a bag replacement. If your bag continues to present an unpleasant odour even when empty, you can place deodorants in the pouch. Some people may opt to learn to irrigate their colostomy by flushing the colon with water through the stoma, eliminating the need for use of a colostomy bag. Used bags should be replaced every so often for your hygiene. What is a Urostomy Bag? A urostomy involves diverting the ureters (which carry urine from the kidneys to the bladder) to a stoma, allowing urine to be drained from the body. The stoma is typically formed as part of an ileostomy, so a urostomy essentially allows the ileum to serve as a conduit for urine removal. Urostomy bags have a tap at the bottom that can be used to drain urine into the toilet, and must be cleaned regularly to prevent unpleasant odours or leaks. Some bags also feature a breathable stoma bag cover that prevents condensation to protect your skin. At night, you will need to connect your urostomy bag to a larger drainage container, so urine can drain while you sleep. Who Needs Each Type of Ostomy Bag? Temporary ostomies are reversible and will require a short-term ostomy bag while you recover and await the reversal procedure. Permanent stomas may present different use cases for each ostomy bag type. You may require a colostomy bag if you have: A form of digestive tract cancer (such as colon cancer) Chronic bowel incontinence Severe trauma to the digestive tract Diverticulitis Crohn’s disease   You may require an ileostomy bag if you have any of the following: Gastrointestinal motility disorders Crohn’s disease Ulcerative colitis Certain cancers   Lastly, a urostomy bag is recommended if you may have: Bladder cancer Chronic bladder infection Spinal cord injuries that affect bladder function Certain birth defects affecting bladder function How to Use and Change an Ostomy Bag Preparations First, prepare all necessary supplies so you have everything on hand and avoid mistakes or misplaced items. Ensure that your changing area is clean and well-lit. Some bags may need you to cut the flange to size. If so, carefully measure your stoma and cut the opening to fit it perfectly. It should not feel too tight or too loose. If you use pre-sized bags, ensure you find one that is the appropriate size for your stoma. Bear in mind that your stoma’s size can change over time after the ostomy procedure. In most cases, the stoma will shrink over time until it stabilises, so your bag will need frequent adjustments for a good fit. The stoma’s shape can also influence your ostomy bag’s fit. For example, some stomas may appear flush against the skin, making it tricky to fit the flange properly. Some bag models feature wafers that are designed for such stoma positions and shapes. Removing the Old Bag If you are wearing the old ostomy bag, gently remove it from your skin. Take it slow to prevent leaks or spills, and then dispose of the old bag in a proper disposal bag or container. Clean Your Skin Use warm water and a soft cloth or skin-friendly wet wipes to clean the stoma area and the surrounding skin. Look out for signs

What is a Prolapsed Stoma? A prolapsed stoma occurs when a small section of the intestine pushes through the stomal opening in the skin. This may happen in individuals who had a colostomy or ileostomy. The amount of protruding intestine can vary from 2-3 cm to more than 10 cm. Although a prolapsed stoma can be alarming when it happens, it is usually not serious and can be managed by visiting your healthcare provider. Learn more about the causes and treatments for a prolapsed stoma below. Causes The stoma may prolapse if the muscles supporting it are weak. It can also happen due to excessive straining on the abdominal muscle, such as through heavy lifting. Other causes include constipation, obesity, or coughing and sneezing too hard. Individuals who have had their stoma prolapsed once are also more likely to experience a prolapse again if there is excessive abdominal pressure. Management and Symptoms Symptoms of Prolapsed Stoma The most obvious symptom of a prolapsed stoma is when you see the intestine protruding through the stoma. The stoma will be longer than usual, sometimes with swelling. Some individuals might only notice it when they are standing, and it may disappear when they are lying down. A prolapse decreases blood supply to the stoma, causing it to turn dark red, purple, or pink. It may also feel cool to the touch. You may experience skin irritation as well as sores on its surface that appear like yellow or white patches. If the stoma is blocked, the stool will not be able to properly empty into the pouch. Treatments for Prolapsed Stoma The stoma prolapse treatment recommended by your healthcare provider depends on your situation, including: Non-surgical treatment If your prolapsed stoma does not cause complications, such as bowel obstruction or strangulation (cut off blood supply to the rest of your intestines), your healthcare provider may recommend non-surgical treatments. This includes gently pressing on the exposed intestine to help it move back into your belly. They may also use a cold compress or pour table sugar on it to reduce swelling and help the intestine move back in place. Your provider may also teach you how to do these treatments on your own in case of another prolapse. Surgical treatment If your provider notices that your prolapsed stoma causes complications, they may perform surgery to remove the prolapsed section of the intestine. They will then attach a new section to replace it and redo the stoma site. Managing Prolapsed Stoma When you experience a prolapsed stoma while you are at home or away from your healthcare centre, you can try lying flat with your head back. Do not look at your abdominal area to prevent straining your abdominal muscles. Try your best to relax, and apply continuous gentle pressure with your hands to help the intestine slide back into your body. Since the stoma tissue is very delicate and easy to injure, a prolapsed stoma can easily get irritated or bleed when rubbing against the pouch opening. Avoid pinching the stoma between the flange, or the plastic piece that fits into the ostomy pouch. Wearing loose-fitting clothes, especially around the waist, can prevent rubbing. While some cases of prolapsed stoma can subside on their own, it is best to let your healthcare provider know if you have it. Your provider will assess your condition and advise how you should look after the stoma, helping reduce the swelling and prevent it from prolapsing again. You may also be advised to get stoma care products that help you conveniently manage your stoma at home, such as: Stoma bags Stoma bags or ostomy pouches help collect waste. They are commonly found in two different types which you can choose from to suit your needs. The first is a one-piece system bag, where the pouch and skin barrier come pre-attached in one piece. The second is a two-piece system, where the pouch and barrier are separated so you do not have to remove the whole system when changing your pouch. In some cases of prolapsed stoma, you may need to get a bigger stoma bag with a larger opening, or choose a flexible pouch as it can expand in size. You may also be advised to empty your stoma bag more often. Skin barriers Skin barriers, also called wafers or flanges, are available in different styles and sizes. If you are unsure which skin barrier to choose, your healthcare provider can provide recommendations. Cleaning supplies Make sure to clean the skin around the stoma regularly to reduce the risk of infection. You can use stoma cleaning products such as skin barrier wipes and adhesive remover wipes. Support belt Ask your healthcare provider whether you need a support belt or hernia belt to hold the stoma in place and protect it from another prolapse. Support belts are garments to hold the stoma in place and protect it. They also help make the stoma bag appear more discreet, while drawing in and helping support the weight of bulges to feel more secure in the core. Do You or a Loved One Need Stoma Prolapse Treatment? Sozo Wound & Stoma Care provides stoma care in Singapore to help manage stoma prolapse. Get in touch with us and let us assist you with our stoma care services!

Living with a stoma is manageable with the support of your doctor, family, and friends. However, many people may experience stoma problems within the first five years after stoma formation. Thankfully, managing these complications is still possible. Common Stoma Problems You May Face Your doctor will notify you of the potential complications you may face with your stoma. Some of the more common ones include: Sudden leakage Sudden bleeding Pancaking or ballooning Skin irritation Blockage in the stoma Retracted or prolapsed stoma Hernias Managing Stoma Complications Leaking Leakage can occur due to a poorly fitted stoma bag or even weight loss, which can influence your stoma’s size and affect the bag’s placement. Leaks can occasionally occur, especially when the stoma’s size changes in the first few months after surgery. You should regularly check that your stoma bag is correctly positioned to reduce this risk. Ensure that the stoma bag’s opening (the flange) fits snugly around the stoma and that there are no gaps between your skin and the flange. Consider using a convex wafer if you have a flat or retracted stoma, which can lead to leakage. Pancaking Pancaking occurs when your stoma’s output becomes stuck at the top of the bag and does not flow into the bag. This is because the stoma bag’s internal layers stick together, preventing the output from settling to the bottom. It could cause a blockage in the bag filter (allowing gas to escape from the bag), skin irritation if the output comes into contact with your skin, or even force the bag off your body. You can blow into the bag before applying it to your stoma to force both internal sides of the bag apart, and then apply the filter cover to retain some air inside the bag. When the stoma functions normally, you can then remove the filter cover to ensure the output reaches the bottom of the bag. Alternatively, place a small, rolled-up tissue into the bag to keep the sides apart. You could also add baby oil or liquid soap to help the output slide to the bottom of the bag. Ballooning Ballooning occurs when the stoma bag inflates due to air introduced into it. This air may be flatulence, in which gas is expelled from the colon through the stoma and collects in the bag. It may also occur when the bag’s filter gets wet or is blocked by stoma output. Some stoma appliances do have an integral filter that you can use to release this air and neutralise any unpleasant odours. Use a sticky patch to prevent the filter from getting wet. You may also need to modify your diet to reduce wind in your digestive tract. These include carbonated drinks, spicy foods, and certain vegetables, such as peas and beans. Eat regular meals to reduce this wind build-up, and avoid drinking while eating to prevent air from being swallowed along with your food. Skin Issues You may also experience skin problems due to: Poorly fitted stoma bags Stoma output in contact with your skin Skin or stoma injury or trauma Skin allergies when using a stoma product   If your skin feels sore or appears red or broken, double-check that your stoma bag snugly fits around your stoma. An ill-fitting stoma bag can cause skin irritation or damage. Look for signs of output on your skin as well, as that will indicate a leak. Check your stoma bag’s condition as well, and replace it immediately if it is damaged. Look out for signs of damage to the stoma as well. Notify your doctor immediately if your stoma’s condition seems concerning. Bleeding The stoma contains plenty of blood vessels, so some minor bleeding can happen. It may also occur when the stoma bag rubs against the stoma. Gently cleaning your stoma with a clean, dry pad will help reduce bleeding, but if it persists or if you notice blood in your stoma bag, contact your doctor immediately. Retraction A retraction is where the stoma lies flat or below the skin’s surface. It can make it difficult to fit your stoma bag, increasing the risk of leaks and sore skin. Managing a retracted stoma may require a convex wafer to push the stoma forward, or using other stoma products to support it and ensure a proper fit. If necessary, surgically repositioning the stoma may help maintain your comfort. Prolapse A prolapse occurs when the stoma extends in length due to increased intra-abdominal pressure, thereby increasing the risk of infection or injury. The stoma can still function normally, but if it changes colour, contact your doctor immediately. You may need to adjust your stoma bag to accommodate the stoma and prevent complications, such as output blockages. Additional cuts of at least 5 mm to your stoma template can ensure your stoma bag fits snugly without causing abrasions. Blockage A bowel obstruction can slow or block the passage of stool through your stoma. A blockage can result from certain foods that are difficult to digest or scar tissue in the bowel, and you may experience symptoms such as: Abdominal pain Stoma swelling Nausea or vomiting Reduced urine output   You may need to reduce solid foods and increase fluid intake to stimulate bowel movement. Warm baths can also help ease abdominal pain, while short walks can stimulate blood flow to your bowel, facilitating bowel movements. You may also try gentle massages around the stoma or your abdominal area to dislodge the blockage. If your abdominal pain or vomiting persists, seek medical attention immediately. Receive Stoma Care with SOZO Wound Care Managing a stoma can be worrying, but rest assured that SOZO Wound Care’s specialists are here to help. Contact us today to learn how we can provide stoma care for you or your loved one.

Living with a stoma requires consistent peristomal skin care, as skin irritation can impact your quality of life. Our article will provide valuable tips to help manage skin irritation and ensure your comfort at all times. Causes of Peristomal Skin Irritation Peristomal skin irritation can stem from various causal factors. Leakage Leakage is the most common cause of peristomal skin irritation and damage. Leaks tend to occur when the stoma’s size changes in the first few months after surgery, but may also be due to an improperly fitted stoma appliance. Pancaking Pancaking occurs when the stoma’s output cannot flow into the bag. It usually happens when the stoma bag’s internal layers stick together, preventing the output from settling to the bottom. This occurrence may expose your skin to waste matter, slowly causing skin irritation. Skin Folds/Creases Sometimes, the area around your stoma may have folds or creases, making it difficult to position the stoma appliance. It could prevent the appliance’s skin barrier or flange from adhering securely to the skin’s surface, leading to leakage. Friction & Pressure Occasionally, friction or pressure on or against the skin could gradually cause damage, thereby increasing the risk of skin irritation. A common cause is wearing a belt, which can rub against the peristomal skin. Infection There may also be a risk of infection, either due to improper cleaning or shaving around the stoma (which can lead to red, pimply skin) or a fungal infection (characterised by reddish, purplish, or white patches). Bleeding While minor bleeding can occur (as the stoma has many blood vessels), if it persists even after light cleaning, contact a wound care nurse or specialist immediately. Improper Appliance Changes Inappropriate removal of the stoma appliance, such as pulling it away from the stoma or picking at the flange edges, can also result in skin irritation. What You Should Do to Care for Your Peristomal Skin To maintain your skin’s health, it is helpful to include these steps in your daily routine. Check Your Skin Frequently A regular skin care routine can help you stay on top of your peristomal skin’s condition. Look for potential warning signs of minor or early skin damage, such as frequent itching or discoloured skin. Be aware of signs of leakage or moisture buildup to prevent gradual skin damage or infection. Healthy peristomal skin should look like the rest of your skin. Some redness is expected when you remove the appliance’s adhesive, but if it persists, consult a wound care nurse or specialist immediately. Change Your Appliance Regularly It helps to change your stoma appliance at regular intervals, typically every 2 to 4 days, or as advised by your wound care nurse or specialist. If you notice moistness, itching, or other irregularities with your appliance on, carefully remove and replace it. Regular changes ensure that your stoma’s condition is appropriately managed and reduce the risk of complications, such as leakage. Ideally, ensure the output bag does not exceed two-thirds of its capacity to prevent leaks or other issues. You can also change the appliance before participating in activities, especially if you feel more comfortable doing so. Be sure to record every time you change your stoma appliance to make your daily stoma care more manageable. Gently Clean the Peristomal Skin Water is usually sufficient to clean the area around the peristomal skin, especially when changing your appliance. Avoid using lotions, creams, or other cleansers that may contain oil or residue, as these can irritate your skin. Gentle, skin-friendly soaps or cleansers are allowed, as long as they are free of additives such as fragrance. You also need to be mindful of your skin’s pH levels (between pH 4 and 5.5), as leakage or other complications can raise or lower pH, making your skin more vulnerable to irritation or damage. Before using any stoma-related products, read the usage instructions carefully or consult a wound care nurse or specialist for advice. Be Aware of Stoma Changes Your stoma’s size can change for various reasons, including weight loss or gain, pregnancy, or other medical conditions. The first few months after surgery may also lead to changes in stoma size. You should constantly adjust your stoma appliance to ensure it fits your stoma properly and prevents complications such as leaks or poorly fitted appliances, which could also irritate the peristomal skin. A stoma measuring guide can be invaluable for regularly tracking your stoma’s size. Take a Skin Break A skin break is when you leave the peristomal skin uncovered for 15 to 30 minutes after removing your stoma appliance. Doing so helps to reduce the risk of irritation by allowing your skin to “breathe”, especially when it is covered by your appliance’s flange for hours a day. Keep a towel, container, or bag over the stoma during this time to prevent leakage. Seek Medical Support If you have any doubts or concerns, seek assistance from a licensed wound care nurse or specialist for additional medical advice, treatments, and preventive care for your stoma. Tips to Reduce Peristomal Skin Irritation Reducing skin irritation can be much easier with these handy tips. Consider the Right Appliance One-piece appliances combine the skin barrier (where the flange is) and the output bag as a single unit, while two-piece appliances allow you to separate the output bag from the skin barrier. When choosing between one-piece and two-piece appliances, consider your overall lifestyle and stoma needs. A one-piece offers simplified appliance application and removal, while a two-piece only requires replacing the output bag. If you are unsure, consult a wound care nurse or specialist for further advice on which option best suits you. Dry Off Properly Drying your skin prevents moisture buildup, which could increase the risk of infection or other complications. Use a dry towel or cloth to gently wipe the peristomal skin clean, and double-check for any spots you may have missed. Double-check Your Fitting When applying your stoma appliance, be sure there are no gaps of skin between the stoma and the