All about your urinary diversion nurse
The stoma care service at Addenbrooke’s Hospital is designed to meet the needs of patients who have undergone bladder surgery which will or has resulted in a stoma. We aim to support in the following ways:
- teaching you the practical care of your stoma
- supporting you and your family in adjusting to life with a stoma
Your stoma care nurses are Nicola Cheale and Catarina Parracho, urology nurse practitioners. We would prefer that you call us by our first names; however, if you do not feel comfortable with this, you can refer to us as 'Nurse'.
We can be contacted Monday to Thursday, 08:00 (8am) until 18:00 (6pm) on 01223 349800 (24 hour answer phone). If we are unavailable, a colleague will deal with messages appropriately. This is a direct line where a 24 hour answer phone is in operation. We will ring you back as soon as I can. Sometimes this may not be until the following day. If you have an urgent problem over a weekend or bank holiday, you will need to contact 111, your general practitioner or a community nurse. If you have access to MyChart (opens in a new tab), you can also message us via that.
What will happen when I leave hospital?
You will not be discharged until you feel confident with managing your stoma. You may be referred to your local district nurse, and usually visited within 48 hours of your discharge from hospital, if needed.
You will be referred to your community stoma care team who will arrange a date for the removal of the stents in the stoma, if these are still in place when you are discharged. You will be given their contact details and they will see you for ongoing support and follow-up.
If you have problems between clinic appointments or in the future, you can always contact us at the hospital and we can arrange to see you in clinic.
You will be telephoned two to three days after discharge and an appropriate follow-up can be arranged as required.
How to obtain your appliances/ equipment
Your stoma products are on prescription. As your stoma is permanent you will be exempt from prescription charges. You will be given an exemption certificate for your GP to sign if needed.
Once you have the prescription, you can obtain your supplies in two different ways.
- Take your prescription to your chemist as you would for any other medicines or tablets. It is important to remember that, generally speaking, chemists do not stock stoma equipment and they will need to order it specially for you. This could take up to one week, so do not wait until you have only two or three bags left before you take your prescription in. If your chemist has trouble ordering your stoma equipment, please contact us for advice.
- There are several delivery companies listed below. You can register with them on the phone or over the Internet and they will send your your stoma equipment free of charge.
They do require a prescription and will ask you to obtain this from your GP and send it on to them. If you are unable to obtain your prescription, they will offer to write to your GP and obtain it for you. They will also send complimentary items such as dry wipes and scented disposal bags.
For those of you having to cut your bags to fit your stoma, if you send a pattern/ template, they will deliver your equipment already cut. Please allow six weeks before asking for this service, as your stoma will need to settle in size and shape. Please ask us if you are interested in this service and require additional support or advice.
Materials used for cleaning around your stoma, such as cleaning wipes, are not available on prescription. However, quilted kitchen roll is an excellent substitute and can be acquired from most shops or supermarkets.
Step-by-step guide to changing your bag
- Collect all necessary equipment:
- new bag
- scissors
- disposal bag / nappy sack / plastic bag
- dry wipe / kitchen roll
- warm tap water
2. If necessary, cut the new bag to the required size or shape
3. Empty the used bag down the toilet and reseal
4. Remove the soiled bag – peeling it off from the top
5. Place the soiled bag in the disposal bag
6. Clean the skin and stoma using warm water and wipes. If you wish to use soap, a milder or non-perfumed soap is recommended and skin must be rinsed thoroughly
7. Dry the skin thoroughly using dry wipes or kitchen roll. Pat dry and check its dryness with your hand
8. Peel off the backing plate from the new bag and position around your stoma. Press the bag firmly in place
9. Wrap the used wipes and the soiled bag in newspaper and put in a plastic bag. Knot or seal the top and place in a household rubbish bin
Night drainage
It is up to you whether you use the night drainage system.
- Always remember to ensure that the bag is lower than the level of the bed.
- When connecting at night, do not empty the bag first. Run the urine through the system as this will reduce air pockets and allow free drainage.
- Once disconnected, wash the bag with hot, soapy water (washing-up liquid or liquid soap).
- Do not wash with Milton, bleach or disinfectant.
- You should change the night drainage bag and adapter every week.
Frequently asked questions
No
It is up to you. No one needs to know unless you wish to tell them.
Both men and women sometimes feel ‘down in the dumps’ after surgery. This is quite normal and we will help you get through it.
Generally speaking, no. A well balanced diet is recommended. You may have a poor appetite after leaving hospital and we recommend small, frequent meals until your appetite returns. Drinking plenty of fluids is essential and we recommend two litres a day.
Yes.
No, all the bags are odour proof. If ever there is a smell (other than when you are emptying or changing the bag) there is either something wrong with the bag, the bottom hasn’t been cleaned effectively when emptying, or there is a small, undetectable leak. Change the bag if this occurs.
No, not if your stoma is permanent, you will now be exempt. We will give you an exemption form if you are not already exempt.
See information below.
Yes, you will. However, you can remove it for bathing or in the shower.
No, but you will need to carry a spare bag, disposal bag, and dry and wet wipes in case you need to change your bag.
In a cool, dry place out of direct sunlight.
Whatever your occupation, once you have recovered from surgery you can return to work.
No, generally speaking.
If you have a good stable relationship before your surgery there should not be any problems. If there are we will talk to you and your partner together, or separately if you wish.
We can discuss this with you. Generally speaking, the answer is yes.
Generally speaking, yes, but consult your surgeon or us for advice.
Yes.
Yes, we are happy to discuss this with you.
Yes, contact us for travel tips and advice.
Yes, the bags are waterproof. There are a number of companies that provide swimwear for stoma patients. Patterned swimwear is best. Please contact us if you would like more information.
Yes, there are some companies that manufacture clothes for some patients, such as high waist trousers and swimwear, as well as underwear. Please contact us if you require further advice on this.
Yes, once you have recovered from the operation, which is normally around three months. For high impact sports such as rugby and squash, it may be worth considering a stoma shield. Please contact us to discuss this further.
Not until six weeks after surgery. You should not drive until you are safe to do an emergency stop. It is also worth checking in the small print of your insurance policy or with your insurance company.
Yes. You can buy a device from car accessory shops that loosens the seatbelt without affecting the safety and mechanism of the belt.
Generally speaking, no, especially if you look after your stoma in the way you have been taught in hospital. If you do experience sore skin give us a ring.
The bag won't normally leak unless your stoma changes shape or size, you allow your bag to get too full, or if the bag is faulty. If you experience recurrent leakage, you should contact your stoma team. If you ignore it, you could lose confidence and your skin could become very sore.
Yes, please see the information below.
We will invite you to open days at which various companies attend with all the latest products for you to see. These are held every 18 months. Also, you can join the Urostomy Association; members are sent regular journals containing information about new products.
Things to be aware of
Bleeding from the stoma
As the stoma has such a good blood supply, slight bleeding may occur when cleaning it. This is nothing to worry about. It may also occur if the appliance is too tight, causing rubbing or irritation. If you experience bleeding from the opening of the stoma, contact us or your GP.
Mucus
Your urostomy is made from a piece of bowel, which will continue to produce mucus. The mucus is white and sticky and will be passed into your stoma bag, or may be evident on the stoma when changing the bag. It can be simply wiped away and should not be mistaken for any signs of infection.
If copious amounts of mucus are passed, it can cause blockage of the drain valve or night bag. This can normally be passed with manipulation.
Vitamin C has been shown to help reduce the amount of mucus and keep the urine clear.
Dietary tips and useful information
For most people, a urostomy has very little effect on diet and you will be able to eat whatever you like. Certain foods may give odour to the urine. This includes asparagus, fish, onions, garlic and some spices.
Drinking cranberry juice (200ml a day) can help to keep urine free from infection and can also help to prevent urine infections. If you are taking warfarin, please check with your doctor before taking cranberry juice.
Beetroot, red fruit and red fruit drinks will turn the urine red. Some medications may also change the colour and odour of your urine.
Before you leave hospital, you should have:
□ Information booklets
□ Exemption certificate (if applicable)
□ Stoma bags / equipment
□ Prescription details and instructions
□ Contact number for local stoma care nurse if you live out of the area
□ Discharge booklet
□ District nurse letter
More information
We are smoke-free
Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.
Other formats
Help accessing this information in other formats is available. To find out more about the services we provide, please visit our patient information help page (see link below) or telephone 01223 256998. www.cuh.nhs.uk/contact-us/accessible-information/
Contact us
Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge
CB2 0QQ
Telephone +44 (0)1223 245151
https://www.cuh.nhs.uk/contact-us/contact-enquiries/