Urostomy: Selecting Your Pouch

After a urostomy, urine drains into a disposable pouch. The pouch sticks to your belly (abdomen) on the skin around the stoma. An adhesive skin barrier holds the pouch in place. This barrier also protects the skin and prevents leakage. Most pouches are made of lightweight, odor-proof plastic and lie flat against the body.

A good pouching system should:

• Stay secure with a good leak-proof seal when applied correctly. Follow any specific instructions your doctor or nurse gives you on changing your pouch.
• Be odor-resistant.
• Protect the skin around the stoma.
• Be nearly invisible under clothing.
• Be easy to put on and take off.
• Allow you to shower or bathe with the pouch on, if you wish to do so.

There are many styles of pouches. Your wound ostomy and continence nurse or your doctor will help you select the one that's best for you. The skin barrier has to fit around the stoma without touching it. The barrier must stick well to prevent leakage or odor from the pouch.

• The skin barrier and pouch come as one piece. The skin barrier holds the pouch onto the skin.
• Urine is emptied from the bottom of the pouch through a drain. The drain can be opened and tightly closed. Drain styles differ depending on the pouch selected.

• The skin barrier and pouch are separate pieces. The skin barrier is applied to the skin. The pouch snaps onto the skin barrier. When the pouch is taken off, the barrier stays in place.
• Urine is emptied from the bottom of the pouch through a drain. The drain can be opened and tightly closed. Drain styles differ depending on the pouch selected.

For the pouch to fit around the stoma, the opening of the skin barrier must be the right size. Some openings are precut, and others must be measured and cut. To find the correct size for your stoma, use a measuring guide. Most pouches come with a guide in the box. Your doctor may also give you one.

• Find the smallest hole on the guide that fits around the stoma without touching it. There should be about 1/8 inch between the stoma and the hole on the guide.
• To cut the opening yourself, center the guide hole on the back of the skin barrier. Trace the pattern. Then cut the opening using curved scissors.
• For precut openings, order pouches with the sized openings that match the size of the hole on the measuring guide.

You can buy other stoma care products through special catalogs, at medical supply stores, online, and at some drugstores. The accessories include the following.

• Moisture barrier powders, pastes, and gels add an extra layer of skin protection. These types of products also help protect irritated skin.
• Stoma paste and skin barrier wafers fill in uneven places in the skin around the stoma. This helps the pouch stick better. Don't use creams, oils, and lotions on the skin around your stoma. These types of products can make it hard to attach the pouch to your skin.
• Convex skin barriers help make a better seal. They are used if the skin around the stoma is uneven or if the stoma is level with or sinks below the skin. Some convex barriers come with a pouch attached. Others are inserts that can be added to any pouch.
• Pouch filters and deodorants help prevent odor.
• Ostomy belts help keep the pouch in place.
• Pouch covers help keep the skin under the pouch dry and comfortable.
• A night drainage system lets you sleep all night without emptying your pouch. It also helps prevent urine from pooling around the stoma, which leads to skin irritation and infection.