A ureterostomy is a surgical procedure where an opening in the abdomen, known as a stoma, is created to allow drainage from one or both of the ureters, the tubes running from the kidneys to the bladder. This procedure may be required when a patient's bladder is removed for the treatment of a condition like bladder cancer or when a patient's bladder function is very poor. The patient will need to wear a collection bag for urine, as the muscles used to control urination are not included in the ureterostomy.
Before a ureterostomy is recommended, the patient is thoroughly reviewed to see if other treatment options are available or more suitable. A urologist may be involved along with practitioners like nephrologists, who specialize in kidney care. If the patient's medical team feels this procedure is the best option, they can provide the patient with information about what to expect and how to manage the stoma after the procedure is over. Generally, patients will need to be hospitalized initially until they are producing urine and appear to be free of infection and other complications.
This surgery is performed while the patient is under general anesthesia, and it is considered an invasive abdominal surgery. Some procedures involve only one ureter, while others will bring both to the abdominal wall. When both are moved, the surgeon can choose between placing one drainage port on either side of the abdomen, bringing them to the same side, or creating a single stoma and linking both ureters to it. The procedure varies in length, depending on the option chosen and the patient's general level of health.
Risks of a ureterostomy can include adverse reactions to anesthesia, especially in patients with existing health problems who may not fare well under the anesthetic, along with the risk of infection at the surgical site. Once the patient recovers, the stoma needs to be cared for and patients who treat the surgical site indifferently or are inattentive may develop infections, leading to reddened, irritated skin around the opening.
Some patients are concerned about having to wear a urine collection bag after a procedure like a ureterostomy. Technology behind these procedures has improved significantly, and the risks of leaks and other issues are much lower than they once were. While wearing a bag, a patient can usually engage in normal activity levels, and specially designed straps and pouches can be used for patients concerned about vigorous athletic activity. The bag can be quickly and easily emptied and changed by the patient.