Urinary Stoma Changes: What to Expect After Surgery

Q: Urinary Stoma Changes: What to Expect After Surgery

Hello： It is normal. <br>If you are still concerned, you can consult a doctor at the hospital again. <br>Wishing you good health.

Urostomy

Hello Doctor: My mother underwent a radical cystectomy for bladder cancer two years ago and chose to have a urinary diversion.
She has been cleaning the stoma daily to manage the intestinal output.
Recently, we have noticed a significant decrease in the intestinal output.
While this has made cleaning easier, we are concerned whether the reduced output is normal.
Additionally, she sometimes passes small stones (not sure if they are calculi) from the stoma; is this also normal? My mother does not have any discomfort, and the stoma appears to be a healthy red color.

Sheng, 20~29 year old female. Ask Date: 2022/08/27

Dr. Liu Mingyue reply Urology

Hello: It is normal.
If you are still concerned, you can consult a doctor at the hospital again.
Wishing you good health.

Reply Date: 2022/08/27

More Info

After a radical cystectomy, such as the one your mother underwent due to bladder cancer, patients often experience significant changes in their urinary function and stoma management. Understanding what to expect post-surgery is crucial for both the patient and their caregivers.

Changes in Stoma Output:
It is not uncommon for patients to notice fluctuations in the output of intestinal fluid from their urinary stoma. The reduction in the amount of intestinal fluid can be attributed to several factors, including dietary changes, hydration levels, and the overall health of the gastrointestinal tract. If your mother has been consuming less fluid or has altered her diet, this could directly impact the volume of output. Additionally, the body may adapt over time, leading to less output as the stoma and surrounding tissues heal and stabilize.

While a decrease in output can be concerning, if your mother is not experiencing any discomfort, pain, or other symptoms such as fever or changes in her stoma's appearance, it may simply be a normal variation. However, it is essential to monitor her hydration status and ensure she is drinking enough fluids, as dehydration can lead to further complications.

Presence of Small Stones:
The appearance of small stones or gravel-like substances being expelled from the stoma can be alarming. These could potentially be small urinary calculi (stones) that have formed in the urinary tract. After a cystectomy, the urinary system undergoes significant changes, and the risk of stone formation can increase due to alterations in urine concentration and flow dynamics.
If these stones are small and do not cause pain or blockage, they may not require immediate intervention. However, it is crucial to report this finding to her healthcare provider. They may recommend imaging studies, such as an ultrasound or CT scan, to assess the urinary tract and determine if there are any larger stones or obstructions that need to be addressed.

Stoma Care and Monitoring:
Maintaining proper stoma care is essential for preventing infections and ensuring the stoma functions correctly. Regular cleaning and monitoring for any signs of irritation, infection, or changes in color are vital. A healthy stoma should appear moist and pinkish-red, indicating good blood flow. If there are any changes in color, swelling, or discharge, it is important to consult with a healthcare professional.

Conclusion:
In summary, while changes in stoma output and the occasional expulsion of small stones can occur after bladder reconstruction surgery, they should be monitored closely. Encourage your mother to maintain adequate hydration and report any concerning symptoms to her healthcare provider. Regular follow-ups with her urologist or stoma care nurse will help ensure that any potential issues are addressed promptly, allowing her to maintain her quality of life post-surgery.

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