May/June 2003
Page 4
Individuals with Urostomies: Fluid Management and Infection
People with urinary diversions no longer have a storage area, a bladder, for urine. Therefore, urine should flow from the stoma as fast as the kidneys can make it. In fact, if your urinary stoma has no drainage after even an hour, it is of serious concern. The distance from the stoma to the kidney is markedly reduced after urinary diversion surgery. Any external bacteria have a short route to the kidney. Since kidney infection can occur rapidly and be devastating, prevention is essential.
Wearing clean appliances and frequent emptying are vital. Equally important is adequate fluid intake, particularly fluids that acidify the urine and decrease problems of odor. In warm weather, with increased activity, or with a fever, fluids should be increased to make up for body losses due to perspiration and increased metabolism.
It is important that you be aware of the symptoms of a kidney infection:
- Elevated temperature
- Chills
- Low back pain
- Cloudy, bloody urine
- Decreased urine output
All ileal conduits normally produce mucus in the urine, which give it a cloudy appearance. Blood in the urine is a danger signal. Thirst is a good index of fluid needs.
Important: If urine is collected for urinalysis, either routine, microscopic (R&M) or for culture and sensitivity (C & S), or if you are asked to give a sterile urine specimen, be sure your doctor and nurse know a sterile specimen must be taken directly from your stoma and not from the pouch. Bacteria build up in the pouch constantly. You will always get a false positive test result.
From The New Outlook, Chicago's North Suburban Chapter via OAB Bulletin, Fall, 2002, via Inside Out On-line May/June 2003.
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