Caring for a Urostomy
You will need to learn how to take care of your urostomy at home. You may also want a family member, caregiver or friend to learn in case you need help.
There is more than one way to care for your urostomy. Before you leave the hospital, make sure that you are comfortable with choosing a pouching system, emptying and changing your pouch, and managing problems that can happen when you have an urostomy.
You will most likely be taught how to manage your urostomy by an ostomy nurse (or Wound Ostomy Continence nurse, sometimes called a WOC nurse) or other special nurse. A WOC nurse is a specially trained nurse who takes care of and teaches people how to take care of their ostomies.
How long will it take to recover after a urostomy?
Most people stay in the hospital for up to 5 to 10 days after a urostomy. Once you go home, you should limit your physical activity and avoid lifting heavy objects for about a month. Talk with your surgical team about specific recovery instructions for you.
After surgery, your stoma may be quite swollen. You may have stents coming out of your stoma. There may also be bruises and stitches around it. While a stoma normally is moist and pink or red in color, it may be darker at first.
Your stoma will change a lot as it heals. It will get smaller and any bruising will go away, leaving a moist red or pink stoma. This may take several weeks.
Caring for an incontinent urostomy
If you have an incontinent urostomy, you will not have any control over when your urine comes out. So you will always need to use a pouching system to catch your urine and protect the skin around your stoma. Your ostomy nurse or doctor will help you find a pouching system that’s right for you.
There are many things to think about when trying to find the pouching system that will work best for you. The length and shape of your stoma, how firm or soft your abdomen is, the location of your stoma, and any scars or skin folds near the stoma need to be considered.
A pouching system can help prevent urine from leaking and protect the skin around your stoma, and contain odor. A good pouching system should:
- Stay secure with a good leak-proof seal that lasts for 3 to 7 days
- Be odor-proof
- Protect the skin around the stoma
- Be nearly invisible under clothing
- Be easy to put on and take off
- Allow you to shower or bathe with the pouch on, if you wish to do so
When you’re trying out your first pouching system, talk with an ostomy nurse or someone who has experience managing urostomies. Someone in the hospital should be able to get you started with equipment and instructions after surgery. You might also want to ask for a referral to home care or an ostomy nurse.
The pouching system you first choose might be the one you continue to use. Or you might need to change to a different pouching system if you gain weight, grow (if a child), or for other reasons. You may need to try different types until you find one that feels good, works well, and is easy for you to use.
Pouches come in many styles and sizes. Your choice of pouching systems should focus on the ones that prevent leakage and protect the skin around your stoma.
All pouching systems have a pouch to collect urine that drains from your stoma and an adhesive barrier (called a flange, skin barrier, or wafer) that protects the skin around your stoma. There are 2 main types of systems available.
- One-piece pouches have the pouch and skin barrier together in the same unit. When the pouch is removed, the barrier also comes off.
- Two-piece systems have a skin barrier separate from the pouch. When the pouch is taken off, the barrier stays in place.
Urostomy pouching systems need to have a valve at the bottom for easy emptying. Pouches are made from odor-proof materials and vary in cost. They can be either clear or opaque and come in different sizes.
It is important to choose a skin barrier of the pouching system that fits your stoma. The opening should be no more than 1/8 inch larger than your stoma.
You may need to cut or mold a hole in the skin barrier to fit your stoma. Or you might be able to buy a skin barrier already sized and pre-cut for your stoma. The size of the hole in the skin barrier is important because it is designed to protect the skin near your stoma from stool and be as gentle to the skin as possible.
Your stoma's size can change if it becomes swollen or for other reasons. For example, after surgery, your stoma might be swollen but it will go down over 6 to 8 weeks. During this time your stoma should be measured about once a week. A measuring card might be included in boxes of pouches, or you can make your own template to match your stoma shape.
Once you have determined the urostomy pouching system and other supplies that work best for you, you will need to find a place to purchase them. Ask your doctor or ostomy nurse for recommendations of ostomy suppliers.
Supplies may be ordered from a mail order company, from a medical supply store, a local pharmacy, or online. For additional help ordering, try contacting the product manufacturer, check your local phone book’s business pages, or check the Internet (try searching for “ostomy supplies”).
- To order pouches, skin barriers, and other ostomy products, you’ll need both the manufacturer’s name and the product numbers.
- Talk with your ostomy nurse about reputable dealers who can supply you with what you need.
- Check with your health insurance to see if they have preferred suppliers for you to order from.
- Keep your supplies in a dry area away from moisture and hot or cold temperatures.
- Order supplies with enough time to allow for delivery. It’s not a good idea to stockpile supplies – they can be ruined by moisture and temperature changes.
Paying for ostomy supplies
Many private insurance plans, Medicare part B and Medicaid will cover the cost of your ostomy care and supplies. However, there are differences between plans that you should know about.
If you have time before your surgery, you might want to contact your health insurance plan and find out whether they cover the costs of ostomy care and supplies and how they pay for these costs. You might want to ask:
- What portion of the costs of ostomy care and supplies will they cover?
- Will you be responsible for any deductibles, copays or coinsurance?
- Are there specific suppliers you should order from?
- Are there limits on how many supplies you can order at a time, such as for a month?
- Are there any limitations on the type of supplies you can order?
- Will they pay the supplier directly, or will you need to pay and then be reimbursed by your insurance company?
An ostomy nurse or the staff in your surgeon’s office may be able to help you find out the answers to these questions as well. They can also help you figure out what types of supplies you are likely to need.
If you have trouble paying for your supplies, there are organizations that might be able to help you. Some companies that make ostomy supplies have assistance programs to help you get free supplies for a while. There are also organizations that help people with ostomies find the supplies they need. Ask your ostomy nurse for suggestions for support options.
The skin around your stoma should look the same as skin anywhere else on your abdomen. But the constant flow of urine from the stoma can irritate the nearby skin.
The pouching system’s skin barrier is designed to protect the skin from urine and be as gentle to the skin as possible. Depending on the design, you may need to cut or mold a hole out for your stoma, or it may be sized and pre-cut.
Right after surgery the stoma is swollen, but it will shrink over the next 6 to 8 weeks. During this time the stoma should be measured about once a week. A measuring card may be included in boxes of pouches or skin barriers, or you can make your own template that matches your stoma shape. The opening on the skin barrier should be no more than 1/8-inch larger than the stoma size to keep urine off the skin.
Here are some other ways to help keep the skin around your stoma healthy:
Use the right size skin barrier opening. An opening that’s too small can cut or injure your stoma and may cause it to swell. If the opening is too large, output could get to and irritate the skin. In both cases, change the skin barrier and pouch and replace it with one that fits well.
Use a skin barrier product that best protects the skin around your stoma. There are several types of skin barrier products. Many pouching systems include a solid skin barrier that sticks to the skin around your stoma. This may be used alone or along with other products, such as pastes, powders, rings, strips or liquid barrier films. You might need to try several products to see what works best for you.
Change your pouching system regularly to avoid leaks and skin irritation. Set a regular schedule for changing your pouch, usually every 3-4 days. Don't wait for leaks or other signs of problems, such as itching and burning.
Be careful when pulling the pouching system away from your skin and don't remove it more than once a day unless there’s a problem. Remove the skin barrier gently by pushing your skin away from the sticky barrier rather than pulling the barrier away from the skin.
Clean the skin around the stoma with water. Dry the skin completely before putting on the skin barrier or pouch. Keep the area dry since urine can leak out at any time.
Watch for irritation and allergies caused by the skin barrier products and pouch you use. Reactions can develop after weeks, months, or even years of using a product. If your skin is irritated only where the plastic pouch touches it, you might try a pouch cover or a different brand of pouch. An ostomy nurse can help you find other options if needed.
Factors that can affect the pouching system seal
The pouching system must stick to your skin. It’s important to change it before it loosens or leaks. The length of time the pouch stays sealed to the skin depends on many things, such as proper fitting, the weather, skin condition, scars, weight changes, diet, activity, and the shape of your body near the stoma. Here are some other things that may affect how long a pouch sticks:
- Sweating will shorten the number of days you can wear a pouch. Body heat, added to outside temperature, will cause skin barriers to loosen more quickly than usual.
- Moist, oily skin may reduce wearing time.
- Weight changes will affect how long you can wear a pouch. Weight gained or lost after urostomy surgery can change the shape of your abdomen. You may need an entirely different system.
- Physical activities may affect wearing time. Swimming, very strenuous sports, or anything that makes you sweat may shorten wear time.
Ostomy belts
Some people like to wear an ostomy belt to help hold their pouch in place. A belt might make you feel more secure by applying pressure to improve the seal of the skin barrier and supports the pouching system, which can get heavy as it fills with urine. Some pouching systems come with loops to attach a belt to.
If you choose to wear an ostomy belt, adjust it so that you can get 2 fingers between the belt and your waist or hips. This helps keep you from getting a deep groove or cut in the skin around the stoma. This can cause serious damage to your stoma and sores (pressure ulcers) on the nearby skin.
People who are in wheelchairs may need special ostomy belts. Supply companies often carry special belts, or an ostomy nurse can talk to you about making one yourself.
Emptying and changing the pouching system
You’ll be taught how to change and empty your pouching system before you leave the hospital.
How to empty your pouching system
Your urostomy pouch will have a drain valve at the bottom, so you can empty it as needed. It’s a good idea to empty your pouch when it’s about 1/3 to 1/2 full. A lot of urine in the bag can make it heavy and damage the barrier seal.
During the day, you will need to empty your pouch about as often as you used to empty your bladder before you had surgery. For many people, that means every 2 to 4 hours, or more often if you drink a lot of fluids. Children may have to empty more often because their pouches are smaller.
To empty your pouch:
- Sit as far back on the toilet as you can or stand facing the toilet.
- Place a small strip of toilet paper in the toilet to decrease splashing.
- Hold the bottom of the pouch up and open the valve.
- Gently empty the contents right into the toilet.
- Close the valve.
- Dry the end of the valve with toilet paper.
At night, you might want to use a night drainage system so you don’t have to get up as often to empty your urostomy pouch.
Using a night drainage system
A night drainage system is helpful when you are sleeping. This system connects to the bottom of your pouch and can hold more urine than your daytime pouch. This lets you sleep without having empty your pouch.
When connecting your pouch to the bedside drainage bag, leave a small amount of urine in the pouch to avoid a vacuum in the system which can prevent your urine from draining into the bedside container.
The bedside container can be hung at the bottom of the bed or placed on the floor.
You will need to clean the tubing and bedside drainage collector every 1 to 2 days. Pour about 2 ounces of a vinegar-and-water solution into the emptied pouch that’s attached to the night drainage system. (Use 1 part of white vinegar to 3 parts of water.) Let it run out of the pouch, through the tubing, and into the collection container. Then pour it out and hang up the night drainage tubing so it can air dry.
Changing the pouch
Different pouching systems are made to last different lengths of time. Some are changed every 3 days or so, and some just once a week. It depends on type of pouch you use.
Your pouch should be changed on a schedule that fits your routine. It’s best to change your pouch system before it starts to leak.
It might be easier to change your pouch in the morning before you eat or drink anything. If this isn’t a good time for you, try to wait at least 1 to 2 hours after drinking fluids so that urine doesn’t get on your skin and supplies while you change the pouch.
Before changing your pouch, clean your hands well and put all your supplies on a clean surface. Clean pouches decrease the chances of germs (bacteria) getting into your urinary system. Some people find it helpful to use rolled tissues, paper towels, or tampons to absorb dribbling urine from the stoma.
Before placing your new pouching system, clean and completely dry the skin around your stoma. Once you place the skin barrier, gently push on the barrier to help it fully adhere to your skin.
At first you may find that changing your pouch can take up to 30 minutes. With time and practice you may be able to change it faster.
Self-care when you have a urostomy
Bathing
Exposure to air or contact with soap and water won’t harm your urostomy. Water will not get into your stoma.
It’s best to only use water while cleaning the skin around your stoma. Soap and bath oil will not irritate your stoma but may interfere with the skin barrier sticking to the skin. If you do use soap, be sure to rinse your skin well.
If you bathe with your pouch off, be sure your skin is cool and dry before you put on a pouch. Otherwise, the heat from a hot bath or shower can make you sweat under the skin barrier which might make it hard to get a secure seal.
If you want to leave your skin barrier and pouch on while you shower or bathe, it can help to dry the collar of your skin barrier with a towel or hair dryer after you are done. This can help prevent your barrier from coming loose.
Shaving hair under the pouch
If you have a lot of hair around your stoma, you might have trouble getting your skin barrier to stick well. The hair might also pull out when you take off the skin barrier which can be painful. Shaving or trimming the hair with scissors may help with this.
It’s recommended that you dry shave the skin around your stoma using stoma powder. Soap and shaving creams have lotions and oils that might make it hard to get a good seal with the skin barrier. After shaving, rinse well and dry the skin around your stoma well before applying your pouching system.
Eating and drinking with a urostomy
You will probably not have any eating restrictions after urostomy surgery. However, if your kidneys have been damaged, your doctor may have you watch your protein and salt intake.
It is important to drink at least 8 to 10 eight-ounce glasses of liquid throughout the day. This helps protect your kidneys and urostomy by keeping your urine flowing all day.
You may be told that it is important to keep your urine pH more acidic. This can help prevent urinary tract infection and lower the risk of crystals forming on your stoma or nearby skin. You can help keep your urine more acidic by drinking cranberry juice instead of orange or grapefruit juice. Or you can take vitamin C or cranberry supplements each day. Check with your health care team before starting a supplement.
Managing Urostomy problems
Since urostomies change the way your urine leaves your body, you may have problems that you are not used to. But there are ways to deal with them.
Blood or crystals on your stoma
Spots of blood on your stoma are not a cause for alarm. Cleaning around the stoma as you change the pouch or skin barrier may cause slight bleeding. The blood vessels in the tissues of the stoma are very delicate at the surface and are easily disturbed.
Any bleeding should stop quickly. If it doesn’t, use gauze to put pressure on the stoma and call your ostomy nurse or your doctor for guidance.
You may also get urinary crystals on your stoma or the skin around it. These crystals look like white, gritty particles. They irritate or cause bleeding on your stoma. Proper cleaning and careful fitting of the skin barrier will help prevent urinary crystals. You may also need to take steps to change your urine pH. Your doctor or WOC nurse will let you know how to do this.
If you get urinary crystals, you can make a compress of equal parts of water and white vinegar and apply it to your stoma for a few minutes when you change your pouch. To do this, soak a bath cloth or small towel in a mixture and hold the moist cloth on the stoma.
Urinary tract infections (UTIs)
Having a urostomy increases your risk of getting a urinary tract infection (UTI). This can happen if bacteria get into your urostomy, ureters, or kidneys. Signs of a UTI include bloody or strong-smelling urine, pain in your abdomen or back, fever and chills. Call your doctor if you notice any of these signs.
You can try and prevent UTI’s by:
- Drinking at least 8 to 10 eight-ounce glasses of liquid each day. Water is a good choice.
- Empty your pouch when it’s 1/3 to 1/2 full to prevent your urine from flowing back into your urostomy.
- Wash your hands thoroughly before and after touching your stoma or pouching system. This includes emptying urine from your pouch, catheterizing your continent urostomy, and cleaning or changing your pouching system.
- Some people feel that drinking cranberry juice helps prevent their UTIs. Check with your health care team before drinking it to see if it might interact with any of your medicines.
Changes in the color and smell of your urine
Some foods and medicines can cause your urine to have a change color or smell. For instance, asparagus, beer, broccoli, fish, garlic, and some antibiotics can make your urine smell stronger. Beets and foods that contain food coloring can change the color of your urine. There are also some anti-cancer medicines, such as doxorubicin, which can change the color of your urine.
If you notice that your urine looks or smells different than usual, check with your health care team. Some changes are not a problem but might mean that you have an infection that needs to be treated.
Skin problems around your stoma
Your stoma most often will not cause pain or discomfort since there are no nerves in your bowels. But the skin around your stoma might become irritated and damaged. This can lead to skin that is red, sore and sometimes weeping (wet all the time).
Skin breakdown around an urostomy stoma may be caused by:
- Urine on the skin around your stoma, if your skin barrier is poorly sized or has started to break down
- Repeated skin barrier removal and replacement
- Being too rough when cleaning the skin around your stoma
- Reactions to the skin barrier or pouching system materials you use
Skin problems can keep you from getting a good skin barrier seal around your stoma, making these problems worse. It’s important to treat minor irritations right away.
Get in touch with your doctor or ostomy nurse if your skin irritation doesn’t get better or gets worse over time. They can help you find the cause of your skin problems and give you medicine or other options to help heal your skin.
If you have irritation or skin damage from a very tight ostomy belt, loosen or remove the belt and call your doctor or ostomy nurse right away. You might need treatment.
When you should call the doctor
You should call the doctor or ostomy nurse if you have:
- Fever or chills
- Abdominal or back pain
- Bloody or bad smelling urine
- A cut in the stoma or injury to the stoma
- A lot of bleeding from the stoma opening (or a moderate amount in the pouch that you notice several times when emptying it)
- Bleeding where the stoma meets the skin
- Bad skin irritation or deep sores (ulcers)
- An unusual change in your stoma size or color
- Fever or strong urine odor (may be a sign of a kidney infection)
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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Last Revised: July 1, 2025
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