Question:

Since receiving a urostomy in October 2023 following a cystectomy for bladder cancer, I’ve been using a two-piece urostomy system. However, I’ve been struggling with frequent leakage, and I suspect I may be doing something incorrectly during the application process. I’m looking for someone knowledgeable about urostomies who can walk me through the proper way to apply the sealing barrier and bag, and help troubleshoot leaks. Are there any resources or people who can guide me? Any advice would be greatly appreciated.

Answer:

Thank you for your question, and I’m sorry to hear you’ve been dealing with leakage issues—it can be very frustrating.

There are many possible reasons for leaks to start or worsen over time, including:

• Changes in abdominal shape due to weight gain, weight loss, or the development of a hernia
• Changes in the stoma itself, such as retraction (sinking below skin level) or the meatus (urine opening) pointing in a direction that interferes with sealing
• Skin changes around the stoma, such as dips or creases, especially near the belly button
• Application technique, such as:
  • Using oil-based soaps or wipes, which can reduce adhesion
  • Not using ostomy paste or barrier strips when needed
  • Not wearing an ostomy belt for added support (if recommended)

To get personalized help, the best first step is to contact your local homecare intake line and request a nurse visit. A nurse can assess the cause of the leakage and provide hands-on support. If the first nurse isn’t experienced in ostomy care, they can refer your case to a NSWOC (Nurse Specialized in Wound, Ostomy, and Continence), depending on the province where you live. No doctor’s referral is needed for this assessment.

With the right support and adjustments, most leakage issues can be resolved. You’re not alone in this, and help is available.

Answered by

Karen Bruton RN BScN MCISc-WH WOCC(C) 
Ostomy Canada (Volunteer)
Medical and Lifestyle Advisory Team Lead