New to urostomy

[MaryChris]

Welcome to the world of urostomy bags! It has been 10 months since my husband’s surgery in September, 2025. I hope my suggestions will help anyone who is new to this process. My husband is 84 years old and I am the one who changes the urostomy bags.
Things I have learned:
1. We change the flange and bag every 2 – 3 days and keep track by marking a small calendar.
2. We found these and they are a game changer for us. They stick so well to the skin and keep everything dry. Medicare will cover the cost or they are available on Amazon: Sure Seal Rings by Active Lifestyle Products, fit 45 mm floating flanges and 57 – 70 mm flanges.
3. Pay close attention to the information on the flanges: 2 ¼ “ would be the size of the circular opening. 1 ¼ “ is the size of the cut to fit opening. Likewise the urostomy pouch must match the 2 ¼ “ size of the circular opening. No one explained this to me.
4. Cautionary Tale: On a trip to Santa Fe, NM, we had the wrong size flange to pouch opening. There was no place to get supplies in all of Santa Fe. If you travel, take double what you think you need and check the openings beforehand.
5. We have had many disasters with night drainage bags coming detached on the tubing connections. I have learned to rinse the night bag every morning twice with hot water. This has cut down but not entirely stopped the breaking loose of the silicone tubing attachment.
6. My husband finds that wearing suspenders rather than a belt maintains the flange’s integrity longer with less leakage disasters.
7. We secure the night tubing to his thigh with these elastic straps: Syhood Compression Bandage wrap for leg. 4/$6.99 from Amazon.

[Shamrock4806]

Thank you for your helpful information.

Question though, isn't 2-3 days rather short on flange wear time?

I have an ileostomy and suffered for years with 2-3 day wear times and it was miserable until I learned a few tricks. Now I routinely get 8-10 days flange wear days.

I don't know how or what of this will help with an urostomy but here it goes:

1: When removing flange, only use adhesive remover on the wafer adhesive not on the barrier adhesive nor any liquid on the skin immediately surrounding the stoma where it goes, instead physically scrape off anything remaining. Dry wipe the stoma clean.

2:.Use oil free eye makeup remover (available in supermarket and drug stores cosmetics cleaning isles) to then soak it around the stoma to clean off any fine remaining residue, especially an invisible film that often remains and builds up, cleans the pores and nourishes the deep skin tissue. Despite the description it.does leave a residue but the next step cleans it off.

3: Using plain ivory like type soap (without moisturizers) water and soap wash the area three times AFTER using whatever to wash the rest of the body with first. Ensure the hands touching the adhesives or the skin immediately surrounding the stoma are washed the same way because skin oils transfer via hands and will ruin the adhesion. Both the fingers and the skin immediately surrounding the stoma needs to be and remain squeaky clean until the device is fully applied to prevent transference of anything that will ruin the bonding process.

4: Dry the hands and stoma area well, usually a short burst of a blow dryer can help with the skin drying out. Also between and before any application (skin protectant, seals,. adhesives etc) using dry new sections of toilet paper to dab up any moisture, that there is one minute hand waving of a hand fan to ensure the skin surrounding the stoma is absolutely bone dry between steps (like after application of lite thin coat of skin protectant for instance).

5: If stoma powder is used it must be just on the leaky wet type wounds and only a very thin crust, any excess dry rubbed removed using dry toilet paper or it causes a micro leak. After one minute of drying, coat the area around the stoma with a thin covering of skin protectant. I find the Coloplast PREP dabber bottle excellent as it creates a thin, very light rough surface which makes for a more secure bonding than a spray or wipe skin protectant which tend to create a more smoother surface.

6: When applying seals ensure ones hands are squeaky clean when touching them as not to transfer any contamination or oils that will ruin the seal and cause an earlier than normal failure. We unconsciously rub our faces and other places where there is more skin oils and transfer them around to coat our skin better. It's how fingerprints are generated as they lack pores. So we need to avoid that unconscious behavior until the wafer is applied. I shouldn't have to mention that using any sort of ointments or powders etc under the wafer will ruin adhesion but I will for others sake.

7: Once the seals and wafer are applied, usually with the patient laying down, apply a firm steady even 5 minute pressure through the wafer around the stoma using something like an empty toilet paper tube with ones palm on top. This will give the adhesives time to warm up and successfully bond well to the skin.

8: Ensure any remaining adhesive is pressed firmly down and bonds well to the skin. Warmth and pressure work. If necessary add barrier strips to the outside around the wafer adhesive applied the same way..I've found a bottom first, slightly stretched then the top strip next to work better than a left and right configuration.

Although more time consuming and tedious, this method has produced 8-10 wafer wear times which is more than 3x as long as typical 3 day wear times. I should mention the reason you don't want any liquids touching the area right around the stoma until the oil free eye makeup remover is because the skin has pores and those pores need to be cleaned and not filled with another liquid or it ruins what we are trying to accomplish.

Good luck and I hope this helps