Vesicostomy and ureterostomy care

What is a vesicostomy?

A vesicostomy is a procedure that lets pee drain from the bladder. A stoma (hole) is made from the skin of the abdomen to the bladder. This creates a way for the pee to drain out of.

Keeping the bladder properly drained can help to stop infections, and keep the kidneys healthy. The pee will either drain into the child’s nappy, or into a bag, if they are no longer in nappies.

What is a ureterostomy?

A ureterostomy is when a stoma is made from the kidney or ureter to the surface of the skin, away from the bladder. This creates a way for the pee to drain out of. Keeping the bladder properly drained can help to stop infections, and keep the kidneys healthy. The pee will either drain into the child’s nappy, or into a bag, if they are no longer in nappies.

Why does my child need this?

Some children aren’t able to empty their bladder properly. There are lots of different reasons why this might be the case.

Some children are born with problems that change the way that the bladder works. If the bladder or kidneys do not work well, this can lead to urinary tract infections. These infections can spread back up to the kidneys and cause damage.

How do I look after it?

If your child’s stoma is draining into a bag, there are a few different bags that you can use. Your specialist nurse will be able to tell you more about these, so that you can choose the best one for you and your child. The nurse will also be able to show you how to change the bags, and look after the bag and skin around it.

Your surgeon or specialist nurse might ask for a catheter (a hollow tube made from a soft, flexible material) to be inserted once a day or more. This is to stop the opening of the stoma from narrowing, so the pee can drain more effectively. Someone from the nursing or medical team will make sure that you know how to do this.

Common problems and solutions

The catheter site looks red and sore

This may be because the skin was not dried properly after washing. This may also be due to the bag leaking and pee being in contact with the skin.

Make sure that the skin around the catheter is properly dried after baths and showers. You can also use a recommended barrier cream.

Make sure that bags are properly attached to try and stop pee leaking onto the skin.

If the problem continues, get in touch with your specialist nurse.

The stoma is bleeding

The stoma and the skin around it is very delicate, like the inside of your cheeks. It can bleed for a little while if it is touched. Any bleeding should only last for a few minutes. It should not hurt, and will not cause any damage.

Check that the drainage bag is still the right size for your child’s stoma.

The skin may try to grow quickly as the body tries to heal the stoma. This may look quite bad, but is not usually a problem.

Please get in touch with your specialist nurse if you are worried, or things do not get better.

There is blood in the catheter

Putting the catheter in can injure the delicate tissue. This can cause bleeding.

Make sure that each new catheter is well lubricated before putting it in.

Get in touch with your specialist nurse if the problem does not get better.

Pain or difficulty putting the catheter in

This might be because the stoma has gotten smaller.

Try using a smaller size of catheter.

Get in touch with your specialist nurse, or visit your nearest emergency department, if you can’t replace the catheter.

Pee is smelly, or the child feels unwell

This might be because of an infection. It can also cause blood in the pee.

Ask your child to drink lots of fluids, ideally 1.5 litres each day.

Take a sample of pee straight from the catheter, not from the bag, and take this to your GP to test.

Frequently asked questions

How often should I empty the bag?

This depends on how big your child is, and how much they drink. You will need to check it regularly, and empty the bag when it is about half full. Make sure the bag is emptied before they do any physical activity or sports. This will help to stop it leaking.

Try to get your child to help with this when they are able. This will help with their independence.

Can my child go swimming?

Children with a vesicostomy or ureterostomy are able to swim, as long as there are no other medical reasons why they should not.

The bag should be emptied before getting into the water.

The bag might need to be replaced when your child comes out of the water.

How do I get more supplies?

Bags, catheters, and valves are available to get on prescription from your GP. Your specialist nurse will let you know about the home delivery service you can sign up for. It is then up to you to get in touch with your GP or the home delivery service when you need more supplies.