Frequent emptying and changing of a pouch can help people take care of their urostomy. It is important to empty and clean the pouch regularly to stop bacteria growth. People will need to empty the pouch when it is around one-third or half full.

Individuals need to empty the pouch as often as they would previously have emptied the bladder. This may mean they need to empty the pouch every 2–4 hours or more frequently for a smaller pouch or if someone is drinking lots of fluids.

This article discusses how an individual can care for their urostomy pouch.

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The urostomy pouch will have a valve at the bottom that allows people to drain urine from it.

To empty the pouch, a person can:

  1. Sit as far back on the toilet as possible.
  2. Place a strip of toilet paper inside the toilet to reduce splashing.
  3. Hold the bottom of the pouch upward to open the valve.
  4. Gently tip the pouch to empty the contents into the toilet.
  5. Close the valve once it is empty.
  6. Dry the end of the valve with toilet paper.

People can use toilet paper or tissues to dry the valve — they do not need to use sterile items.

Individuals may find it helps to use a larger drainage bag at night. They can attach it to a flexible tube via the valve of the urostomy pouch, preventing the need to get up at night to empty it.

People may need to change a urostomy pouch every 3–7 days, although this can depend on the specific pouch they have.

To change the pouch, the American Cancer Society recommends that people find a regular schedule that works for them. For example, changing it might occur first thing in the morning before eating or drinking or waiting 1–2 hours after drinking fluids.

A person should also:

  • Find a comfortable position where they can clearly see the stoma.
  • Clean the hands with soap and water, as well as any surfaces that supplies are on, to help reduce bacteria.
  • Position themselves over a toilet or use toilet paper to absorb any urine that may come out of the stoma.

If using a wheelchair, it may help to sit toward the edge of the chair and lean back slightly.

To remove the pouch, people can use one hand to support the skin and use the other to gently pull the pouch off or remove it from the skin barrier.

They should then place the pouch into a disposal bag, gently clean the stoma area with warm water, and pat it dry.

To fit the new pouch, a person should place it over the stoma and smooth it into place or attach the pouch to the skin barrier.

People may need to allow up to 30 minutes the first time they change the pouch. They may be able to change the pouch quicker with practice.

It is important to keep the seal strong so that the pouch sticks to the skin — otherwise, it may loosen and leak. Factors that can affect how long a pouch sticks to the body include:

  • sweating or moist skin
  • how well the pouch fits with the body
  • changes in weight
  • oily skin
  • strenuous activity
  • swimming

To keep the seal strong, people can make sure to:

  • Wear a properly fitting pouch.
  • Dry the skin properly before fitting the pouch.
  • Warm the bag on the body before fitting it.
  • Smooth the bag on the body to get rid of any creases.
  • Hold the pouch to the skin for 30–50 seconds, so it molds to the body.

People can bathe with or without the pouch.

To clean the area around the stoma, it is best to just use water. If the pouch is off, a person should take care to dry the skin thoroughly and let it cool before replacing the pouch.

To protect the skin around the stoma, individuals should:

  • use the correct size pouch and opening for them
  • change the pouch regularly
  • gently push the skin away from the barrier to remove a pouch
  • avoid removing a pouch more than once a day if there is no issue with it

If certain products start to irritate the skin, a person can try alternatives or speak with a healthcare professional for advice.

Are spots of blood on the stoma a cause for concern?

Spots of blood on the stoma are not typically a cause for concern. The surface of the stoma has delicate blood vessels, which can bleed easily with cleaning or changing the pouch.

However, if any bleeding does not stop quickly, contact a doctor.

Shaving hair under the pouch

Removing hair from under the pouch may help it stick to the skin better.

People may want to carefully trim the hair with scissors or dry shave the skin with a razor and stoma powder. After hair removal, they should rinse and dry the area and replace the pouch.

People can order ostomy supplies from a local pharmacy or online supplier. They can check if their healthcare insurance covers the supplier.

Individuals should store ostomy supplies in a dry area at a moderate temperature, such as a drawer or box.

However, they should avoid stockpiling supplies, as moisture and temperature changes may affect them.

People will need to contact a doctor if they experience:

  • a stoma cut or injury
  • a lot of bleeding from the stoma
  • severe skin irritation
  • unusual changes in stoma size or color
  • urine with a strong odor
  • a fever

Regular emptying and changing of a urostomy pouch may help prevent the pouch from loosening, leaking, or causing skin irritation.

If people notice any unusual changes or have difficulty using a urostomy pouch, they can talk with a doctor or ostomy nurse.