Urostomy - Possible Complications & Urine Infection Treatment
While not as good as a normal bladder, an ileal conduit with a well fitted, well functioning appliance is often the next best thing. It enables people to live near-normal lives with few restrictions. Complications are usually minor and can be dealt with easily when there is close cooperation between ostomate, stomal therapist and surgeon.
A defect with an ileal conduit as opposed to the normal bladder is that it can be quite seriously infected without causing any symptoms noticeable to the urostomate. If this is unrecognised then the infection can develop into a more severe one with complications. Therefore regular taking of specimens of urine or examination using a catheter inserted into the conduit to look for silent infections is sometimes advised. Special combined catheter/specimen containers are available to easily do this. Bag specimens of urine are useless as they are usually contaminated by the stoma and the skin.
Stone formation is usually a result of infection, inadequate fluid intake and dietary factors. Kidney damage can result from uncontrolled infection or be a relection of the back pressure effects.
Reabsorption of some urine constituents in the ileal conduit, especially chloride and acid, can occasionally cause nausea, vomiting, lethargy, over breathing and even coma. This can be prevented by treatment from your doctor, and detected early by blood tests.
Urine appears intermittently at the stoma, being discharged in small spurts, but ejection of urine in narrow, long streams indicates obstruction at the stoma. This may require surgical attention.
Crystals may form in the urine, some being deposited on the skin immediately around the stoma. At each appliance change the crystals should be thoroughly rinsed away to prevent skin excoriation.