Changes in Stoma Output After Bladder Removal Surgery

Q: Changes in Stoma Output After Bladder Removal 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.

Radical cystectomy

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

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

Dr. Du Shixi 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: 2022/08/29

More Info

Understanding changes in stoma output after bladder removal surgery is crucial for both patients and caregivers. Your mother’s situation, following a radical cystectomy and urinary diversion, is not uncommon, and there are several factors to consider regarding the changes in stoma output and the presence of small stones.

Changes in Stoma Output
1. Decreased Output: A reduction in stoma output can occur for several reasons. After bladder removal, the body adapts to the new urinary diversion system. If your mother has noticed a significant decrease in the volume of intestinal fluid being secreted, it could be due to several factors:
- Dietary Changes: Changes in diet can affect the amount of fluid and waste produced. If she has been consuming less fluid or has altered her diet, this could lead to decreased output.

- Hydration Status: Adequate hydration is essential for maintaining normal stoma output. If she is not drinking enough fluids, this could result in lower output.

- Bowel Function: The bowel may adapt over time, leading to changes in the secretion of intestinal fluids. This adaptation can result in less output as the body learns to manage the new urinary diversion.

2. Normalcy of Changes: It is generally considered normal for stoma output to fluctuate. As long as your mother is not experiencing any discomfort, pain, or other concerning symptoms, a decrease in output may not be alarming. However, it is always best to monitor for any significant changes and consult with her healthcare provider if there are concerns.

Presence of Small Stones
The occurrence of small stones or gravel-like substances being expelled from the stoma can be concerning, but it is not uncommon. Here are some points to consider:
1. Possible Causes:
- Mineral Deposits: These can form in the urine, especially if there are changes in urine concentration or pH. This can lead to the formation of small stones or crystals that may be expelled through the stoma.

- Dehydration: Insufficient fluid intake can lead to concentrated urine, increasing the likelihood of stone formation.

- Dietary Factors: Certain foods can contribute to stone formation, particularly those high in oxalates, calcium, or purines.

2. When to Be Concerned: If the stones are accompanied by symptoms such as:
- Pain or discomfort around the stoma
- Changes in the color or consistency of the output
- Signs of infection (fever, chills, or unusual odor)
- Any bleeding from the stoma
In such cases, it is essential to seek medical advice. A healthcare provider may perform imaging studies or urine tests to determine the nature of the stones and recommend appropriate management.

Conclusion
In summary, changes in stoma output after bladder removal surgery can be normal, especially if there are no accompanying symptoms of distress or discomfort. The presence of small stones may also be a benign occurrence, but it is crucial to monitor for any additional symptoms that may indicate a problem. Regular follow-ups with her healthcare provider are essential to ensure that her urinary diversion is functioning well and to address any concerns that may arise. Encouraging adequate hydration and a balanced diet can also help maintain optimal stoma output and reduce the risk of stone formation.

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