Urinary Diversion - Ostomy Home Care

You may have many concerns and questions as you recover from your ostomy surgery. This page includes information that will help answer your questions as they arise, and reinforce the instructions you received during your stay at Roswell Park Cancer Institute.

The Enterostomal Therapy (ET) Nurse, who specializes in ostomy care, is available to answer questions or assess problems you may have in caring for your ostomy.

Our goal is to help you gain the confidence needed to care for your ostomy at home. Dealing with all aspects of your illness can become overwhelming. Remember, you are not alone. Someone is here to help you return to a normal way of life.

Support services are only a telephone call way:

  • United Ostomy Association : 1-800-826-0826
  • American Cancer Society: 1-800-ACS-2345
  • RPCI Ostomy Support Group: (716) 845-8506 or 845-4891
  • RPCI Department of Social Work : (716) 845-8022
  • ET Nurses:
    • Lucia Scarpino, RN, MS, CWOCN : (716) 845-8506
    • Melissa Hiscock, RN, BSN, CWOCN: (716) 845-4891

Stoma Care

  • The stoma should be pink/red and moist.
  • The stoma may be swollen at first, and its size and shape will change over the next eight weeks. Adjust the wafer opening as needed to accommodate these changes.
  • Clean the stoma gently with cool water; vigorous rubbing will cause bleeding. If bleeding occurs, apply gentle pressure with a cold washcloth until it stops. If you cannot stop the bleeding, contact your physician.
  • If blood thinners are prescribed, avoid trauma and hot water to the stoma.
  • White, gritty urine crystals caused by alkaline urine may appear on the stoma or skin, or inside the pouch and night drainage container. Urine crystals can be dissolved by cleansing the skin, stoma, or pouch with half-strength white vinegar and water.

Skin Care

  • Skin care is essential for ostomy care.
  • Each time you change your appliance (pouch and wafer), check your skin for hair, redness, irritation, rashes, sores, or ulcers.
  • Use a soft washcloth or paper towels and mild soapy water to clean your skin.
  • Avoid pre-moistened baby wipes and soaps with oil/moisturizers. These can leave residues on your skin and interfere with the adherence of your pouching system.
  • Trim body hair around the stoma with an electric razor or rounded-end scissors every week.
  • Dry skin well with a paper towel or hair dryer set on the COOL setting prior to applying new wafer.
  • A cloth pouch cover placed over the pouch or a cotton cloth placed between the pouch and your skin will help prevent skin irritation caused by excessive perspiration under the plastic pouch.

Bathing and Showering

  • Showers may be taken with the ostomy appliance on or off. Be aware that your urine will drain from the stoma while the appliance is off.
  • Wear the ostomy appliance while bathing, swimming or in hot tubs.
  • Avoid harsh massage jets and/or forceful water directly on the stoma.

Clothing

  • You should be able to wear the same clothing you wore before surgery.
  • Avoid clothing that puts direct pressure on the stoma.
  • Avoid tight belts and large belt buckles over or near the stoma.
  • Wear stretch underwear to support the pouch during physical activity.
  • The pouch can be placed inside or outside your underwear, whichever is more comfortable.
  • Girdles and pantyhose should be one size larger than normal.
  • Bathing suits with print design and/or skirts/ruffles will help conceal the ostomy appliance. Print /design shirts and layered clothing also help conceal the appliance.

Food and Beverages

  • You can resume your normal diet following surgery if there is no medical reason for a special diet.
  • Eat a balanced meal to maintain your weight. Gaining or losing weight could affect the fit of your pouching system.
  • You will need to increase your fluid intake to keep your kidneys functioning and to prevent a urinary tract infection.
  • Drink at least six to eight glasses of water/water-based beverages daily. Adequate water intake will help maintain the urine at its correct acid level, reduce salt crystal formation and prevent bacterial growth.
  • Mucous shreds are normal. If the mucous clogs the drain spout of the pouch, remove the pouch and rinse with water. Increasing fluid intake will help alleviate this problem.
  • If your urine becomes dark, cloudy or foul-smelling, or you develop chills and a fever, and you have pain in your lower back, contact your physician, as this could be a sign of a urinary tract infection.
  • Certain foods, such as asparagus, garlic, onions, and some fish oils may produce a strong odor in the urine. You do not have to eliminate these foods. Drinking fluids will keep your urine diluted and decrease odors. Remember, the pouch you are wearing is odor-proof. Urine odor will occur only when you empty the pouch in the toilet.

Medication

  • Some medications and foods may alter the color and/or consistency of the urine. For example, vitamins may turn the urine bright yellow, and eating beets may turn the urine red.
  • Discuss your medications with your pharmacist.

Activity, Exercise, and Sports

  • Ostomy surgery should not prevent you from exercising or being physically active.
  • After a six-week recovery period, you may increase your activity level moderately, as tolerated.
  • To prevent a hernia, do not lift more than 8 pounds (a gallon of milk = 8 lbs.) for the first six weeks after surgery.
  • An ostomy support belt is strongly recommended to prevent a hernia when lifting and/or using abdominal muscles. The ostomy support belt will need to be fitted, and a prescription is required. The belt can be obtained wherever you get your ostomy supplies.
  • Exercise, sports, and swimming are excellent activities to improve strength and physical well-being. Rough contact sports should be avoided.
  • You may put tape around the edge of your wafer for support before swimming.
  • Empty your pouch before swimming or activities.

Returning to Work

  • After a six-week recovery period, your physician will evaluate your ability to return to work.
  • Always keep extra supplies at work or in a briefcase. Be sure to store equipment at room temperature.

Traveling

  • When traveling, take at least twice the amount of supplies you usually need.
  • When flying, carry your supplies with you. Do not place supplies in checked luggage or in a storage compartment.
  • Pre-cut your products before flying, and store your scissors in your checked luggage.
  • Place your seatbelt above or below your stoma.
  • Carry identification specifying your particular ostomy and equipment.
  • Carry a list of United Ostomy Association chapters and/or your manufacturer’s toll-free number in your travel case. These are excellent resources if assistance is needed when traveling.
  • When you travel to warmer climates, heat and moisture can decrease your wear time.

Personal Relationships

  • Having an ostomy will not interfere with social, personal, and/or intimate relationships. Your sexual well-being was part of you before surgery and cannot be erased as a result of surgery.
  • Intimacy and sexual relationships may resume after the six-week recovery period. Your physician will inform you of any restrictions and/or limitations.
  • Empty your pouch before intimate moments.
  • A beige pouch or pouch cover can conceal pouch contents.
  • Intimate apparel is available that can conceal and support the pouch.
  • Counseling with certified sex therapists is available if you have questions or concerns. Contact the Department of Social Work at RPCI for further assistance.

Ostomy Equipment & Storage

  • After surgery, you will be fitted for an appropriate appliance and taught how to use it.
  • Many ostomy equipment options are available. If your current system is adhering for five to seven days, continue to use it. A weight gain or loss of 10 to 15 lbs. and/or an allergic reaction to the equipment may indicate a need to change the system. Please contact your ET Nurse for assistance.
  • Be sure to keep enough supplies on hand to allow for delivery time for your next order of supplies.
  • Change the appliance (pouch and wafer) every five to seven days. Date the wafer or mark the day on your calendar. If your appliance is not lasting five to seven days, please contact your ET Nurse for assistance.
  • Empty your pouch when 1/3 full.
  • Pouch covers are available at medical supply stores. They may be beneficial if the plastic pouch irritates your skin.
  • Use a plastic mattress cover if you are concerned about soiling the bed.
  • Store unused items in the original box in a cool, dry place.
  • Periodically check expiration dates on unused equipment.
  • Contact the equipment manufacturer at the toll-free number to replace defective equipment.

Insurance

  • Check with your health insurance company regarding coverage for your ostomy supplies.
  • A prescription for your supplies will be provided when you are discharged from the hospital.
  • Call several medical supply stores and/or home delivery companies for competitive pricing.

Ordering Supplies

  • Ostomy equipment may be obtained from your local pharmacy, medical supply store, or home delivery company.
  • It is important to find a supplier as soon as possible. When you are discharged from the hospital, you will be provided supplies for 2-3 weeks.
  • Order ostomy equipment before your supply diminishes, allowing enough time for delivery.
  • Keep a list of equipment, product numbers, manufacturers, and suppliers at home. Give a copy to a family member/friend.

Contact your physician if:

  • You are experiencing signs/symptoms of a urinary tract infection:
    • Blood in the urine.
    • Fever.
    • Feeling of general weakness.
    • Urine output has decreased and/or becomes cloudy, with a strong odor.
  • Persistent bleeding from stoma.
  • Change in appearance of the stoma (persistent swelling, color change other than pink/red, remarkable decrease in size).

Contact your ET Nurse if:

  • Appliance is not fitting properly or not lasting 5 to 7 days.
  • Skin surrounding the stoma becomes red, sore, blistered.
  • You have further questions regarding ostomy care, diet, exercise, or support group referrals.