Catheter for Urinary Stomas in Children: Care Instructions

Your child has had surgery to create an opening in the belly called a stoma. This stoma connects to the bladder.

There are two main types of urinary stomas. One type uses a bag that collects urine all the time. The other type works differently. It's called a continent stoma. Urine stays inside the body until you drain it with a thin tube called a catheter.

Your child has this second type of stoma. You insert the catheter into the stoma a few times a day to drain the urine.

Your child may have needed this surgery because of a health problem they were born with, such as spina bifida or a bladder that did not form the usual way. Doctors often create this type of stoma using the appendix. This is called a Mitrofanoff procedure. If the appendix can't be used, doctors can use a small piece of bowel instead. This is called a Monti channel.

Learning to use a catheter can feel unfamiliar at first. But with practice, many children learn to manage this step themselves. Most kids who have this procedure go on to live full, active lives.

• To catheterize your child:
  1. Wash your hands well.
  2. Gather your supplies, including the catheter and lubricant.
  3. Put a small amount of lubricant on the tip of the catheter.
  4. Gently guide the catheter into the stoma until urine starts to flow.
  5. Let the urine drain fully. Then remove the catheter.
  6. Clean the catheter, and store it for reuse.
• Catheterize your child every 3 to 4 hours during the day, and at least once at night. Ask your child's doctor for the exact schedule that's right for your child.
• Check the skin around the stoma often. Watch for redness or irritation, and keep the area clean and dry. A little mucus around the stoma is normal, since the tunnel is made from a piece of intestine.
• Wash the catheter with warm, soapy water after each use, then let it air-dry. Replace the catheter if it looks worn or cracked.
• After your child has healed from the surgery, most activities are fine, including swimming, school, and sports. Ask your child's doctor about contact sports.
• When you travel, pack extra supplies and keep catheters in a clean bag.

Call 911anytime you think your child may need emergency care. For example, call if:

• Your child cannot insert the catheter and seems to be in pain or very upset.
• Your child has severe belly pain.
• Your child has a high fever with vomiting.
• There is heavy bleeding from the stoma.

Contact your doctor now or seek immediate medical care if:

• You have trouble inserting the catheter or can't drain urine.
• You notice redness, swelling, or bad-smelling drainage around the stoma.
• Your child has symptoms of a urinary tract infection. These may include:
  • Pain or burning when your child urinates.
  • A frequent need to urinate without being able to pass much urine.
  • Pain in the flank, which is just below the rib cage and above the waist on either side of the back.
  • Blood in your child’s urine.
  • A fever.

Watch closely for changes in your child’s health, and be sure to contact your doctor if:

• You have concerns about your child's catheter or stoma.