Ostomies and Bladder Cancer

If you have bladder cancer, some medical jargon may feel confusing. Many medical terms sound similar but have different meanings. This is the case with words you may have heard that end in "ostomy," including urostomy, colostomy, and ileostomy.

Put simply, an abdominal ostomy is a surgical opening made in the belly skin. Surgeons may create an abdominal ostomy to help fluids leave the bladder or help waste leave the bowels.^1,2

Here are the 3 main types of abdominal ostomies and when people need them.

Urostomy

When everything is working normally, urine leaves the kidneys and moves through the tubes that connect them to the bladder (ureters). The urine collects in the bladder until the process of urination releases it from the body. When this process does not work properly, a urostomy can surgically redirect how urine leaves the body.³

When is it needed?

Urostomies are used when the bladder needs to be bypassed or when it has been fully removed. People who have loss control of their bladder from bladder problems sometimes find relief from a urostomy.³

How does it work?

First, a doctor makes an opening in the belly called a stoma. Urine then passes through the stoma instead of through the urethra. The stoma will have a round or oval shape. Some stomas are flush with the skin, but others may stick out a little.³

With a conventional urostomy (incontinent urostomy), the surgeon makes what is called an ileal conduit. This means they re-form the lowest part of the small intestine (the ileum) into an internal pouch to collect the urine. The ureters are then redirected to the new pouch, one end of which is sewn to the stoma. The flow of urine can not be controlled, and an external urine collection pouch is needed at all times.⁴

In a different type of urostomy, called a continent urostomy, the surgeon creates an internal pouch with valves. The valves keep the urine from backing up into the ureters and also from freely flowing out of the stoma. This type of urostomy must be drained 4 or 5 times a day with a flexible tube called a catheter.⁴

Colostomy

A colostomy surgically redirects how solid waste, or stool, leaves your body. When the bowels are working properly, stool leaves through the rectum and anus. But sometimes, injury or disease results in the need to get rid of waste differently.⁵

When is it needed?

Sometimes people need a temporary colostomy to allow their bowels to heal from disease or injury. Other times, they may need a permanent colostomy due to a disease such as cancer.⁵

How does it work?

A surgeon diverts a section of the large intestine (colon) through the abdominal wall to make a stoma. Waste is then diverted through the stoma. The location of the stoma depends upon the area of the bowel that is affected.⁵

The stoma does not have a shut-off valve, and stool needs to be collected in a fitted bag. The body will still digest food as before, but it will pass it out of the body differently.⁵

Ileostomy

Like a colostomy, an ileostomy also surgically redirects how solid waste leaves your body.⁶

When is it needed?

An ileostomy may be needed for 3 to 6 months to recover from injury or illness. But sometimes, it is needed permanently due to a disease such as cancer.⁶

How does it work?

People who have a permenant ileostomy have their colon and rectum removed. The end of their ileum is then brought through their abdominal wall to form a stoma.⁶

As with a colostomy, waste will flow through the stoma and need to be collected in a pouch.⁶

Which ostomy is right for you?

If you have bladder cancer, you want to know what will happen if your bladder can no longer function properly or if it needs to be removed. It is possible that you will need a urostomy. While not every person with bladder cancer needs a urostomy, some do.

If you have questions, talk to your doctor about what to expect.