Health Library

Procedures

Welcome to our health education library. The information shared below is provided to you as an educational and informational source only and is not intended to replace a medical examination or consultation, or medical advice given to you by a physician or medical professional.

Understanding Vasectomy

Vasectomy is a simple, safe procedure that makes a man sterile (unable to father a child). It is the most effective birth control method for men.

Your Reproductive System

For pregnancy to occur, a man’s sperm (male reproductive cells) must join with a woman’s egg. To understand how a vasectomy works, you need to know how sperm are produced, stored, and released by the body.

The urethra is the tube in the center of the penis. It transports both urine and semen. When you have an orgasm, semen is ejaculated out of the urethra.
The seminal vesicles and the prostate gland secrete fluids called semen. This sticky, white fluid helps nourish sperm and carry them along.
The epididymis is a coiled tube that holds the sperm while they mature.
The scrotum is a pouch of skin that contains the testes.
The testes are glands that produce sperm and male hormones.
The vas deferens are tubes that carry the sperm from the epididymis to the penis.
Sperm (shown magnified) carry genetic material.

How a Vasectomy Works

During the procedure, the two vas deferens are cut and sealed off. This prevents sperm from traveling from the testes to the penis. It is the only change in your reproductive system. The testes still produce sperm. But since the sperm have nowhere to go, they die and are absorbed by your body. Only a very small amount of semen is made up of sperm. So after a vasectomy, your semen won’t look or feel any different.

Keep In Mind

After a vasectomy, some active sperm still remain in the reproductive system. It will take about 3 months and numerous ejaculations before the semen is completely free of sperm. Until then, you’ll need to use another form of birth control.

Cutaway view of male reproductive system

Vasectomy: Risks and Complications

A vasectomy is an outpatient (same day) procedure. It can be done in a doctor’s office, clinic, or hospital. Before your vasectomy will be performed, you’ll be asked to read and sign a consent form. This form states you’re aware of the possible risks and complications and understand that the procedure, though usually successful, is not guaranteed to make you sterile. Be sure that you have all your questions answered before signing this form. After the procedure, if you have any of the following or other symptoms you’re concerned about, call your doctor.

Possible Risks and Complications of Vasectomy

Vasectomy is a safe procedure. But it does have risks, including bleeding and infection. You may also have any of the following after surgery:

Sperm granuloma is a small, harmless lump that may form where the vas deferens is sealed off.
Sperm buildup (congestion) may cause soreness in the testes. Anti-inflammatory medications can provide relief.
Epididymitis is inflammation that may cause scrotal aching. This often goes away without treatment. Anti-inflammatory medications can provide relief.
Reconnection of the vas deferens can occur in rare cases. This makes you fertile again and can result in an unwanted pregnancy.
Sperm antibodies are a common response of the body to absorbed sperm. The antibodies can make you sterile, even if you later try to reverse your vasectomy.
Long-term testicular discomfort may occur after surgery, but is very rare.

No-Scalpel Vasectomy

The no-scalpel procedure is similar to a traditional vasectomy in many respects, but it’s done without incisions or stitches. This generally results in faster healing.

Talk to your health care provider on how to prepare for the procedure, and about any risks and complications.

During the Procedure

You’re asked to undress and lie on the exam table. Sterile drapes are placed over you to help prevent infection.
You’re given injections of anesthetic into your scrotum or lower groin to prevent you from feeling pain.
Once the anesthetic takes effect, the doctor makes one puncture in the scrotum with a pointed clamp. Each of the two vasa deferentia is lifted through this puncture.
The vasa are cut, and a section of each may be removed. You may feel a pulling sensation during this process.
The two cut ends are sealed by heat (cauterized) and may also be tied or clipped. The puncture heals naturally without stitches.

After the Procedure

If you’ve been given medications to help you relax, you’ll need to have someone drive you home. The local anesthetic begins to wear off after an hour or so. Any discomfort you feel is usually very mild. If you need it, a pain reliever may help.

During Your Healing

Recovery time after a no-scalpel vasectomy is usually less than after a traditional vasectomy. Once you’re home, you can do several things to aid your recovery:

Stay off your feet as much as possible for the first day to lessen the chance of swelling. An ice pack can also help keep swelling down.
Wear snug cotton briefs for support.
Avoid heavy lifting or exercise for at least 5 days.
Ask your doctor when you can return to work.
Ask your doctor when you can begin having sex again. Note: You must use some form of birth control until your doctor says you’re sterile.

Vasectomy Reversal

Each of a man’s testicles makes sperm (male reproductive cells). Sperm travel from the testicles to the penis through one of two tubes called the vas deferens. On the way, sperm mix with other fluids to form semen, which leaves the body during ejaculation. During a vasectomy, each vas deferens is cut, blocking sperm from leaving the body. This makes you sterile (unable to make a woman pregnant). A vasectomy can sometimes be reversed, restoring the flow of sperm out of the body.

How the Procedure Works

During a vasectomy reversal, the two cut ends of the vas deferens are stitched back together. With the sperm pathways restored, sperm can once again travel through the vas deferens and leave the body during ejaculation. You may then be able to father a child.

Preparing for the Procedure

You will be given instructions to prepare for the vasectomy reversal. Tell your healthcare provider about any medications you take, including aspirin. You may be asked to stop taking some or all of these. On the day of your procedure, bring clean cotton briefs or an athletic supporter with you.

During the Procedure

You’ll receive medication to keep you comfortable. You may be awake and relaxed during the procedure. Or, you may be completely asleep. Once the medication takes effect:

An incision is made in your scrotum.
The cut ends of each vas deferens are lifted out and examined. A section of each cut end may be removed.
The end closer to the testicles is cut until fluid flows freely. This fluid may be looked at under a microscope to see if sperm are present.
The two cut ends are stitched together. If needed, the vas may be attached directly to the epididymis (tissue behind the testicle).
When both of the vas deferens are reconnected, the incisions in the scrotum are sutured closed.

After the Procedure

You may need to stay in the hospital for several hours. When it’s time to go home, have an adult family member or friend drive you. Once you’re home:

Take medication as directed to relieve any pain.
To lessen the chance of swelling, stay off your feet as much as you can for the first day.
Place an ice pack or bag of frozen peas (wrapped in a thin towel) on your scrotum for short amounts of time. This helps reduce swelling.
Wear snug cotton briefs or an athletic supporter for extra support.
Follow your doctor’s instructions for showering and bathing.
Ask your doctor when it’s okay to have sex.
Avoid heavy lifting or exercise for at least 2 weeks. Ask your doctor when you can return to work.

Possible Risks and Complications

Risks associated with anesthesia.
Infection (symptoms include fever, chills, drainage from the incision site, and pain).
Internal bleeding of the scrotum (symptoms include increasing pain, excessive swelling, a large black-and-blue area, or a growing lump).
Failure of the procedure to restore fertility.

Having a Vasectomy: Before, During, and After the Procedure

Vasectomy is an outpatient (same day) procedure. It can be done in a doctor’s office, clinic, or hospital. Your doctor will talk with you about preparing for surgery. He or she will also discuss the possible risks and complications with you. After the procedure, follow all your doctor’s advice for recovery.

Preparing for Surgery

Your doctor will talk with you about getting ready for surgery. You may be asked to do the following:

Sign a consent form. This must be done at least a few days before surgery. It gives your doctor permission to do the procedure. It also states that a vasectomy is not guaranteed to make you sterile.
Don’t take aspirin, ibuprofen, or naproxen for 2 weeks before surgery. These medications can cause bleeding after the procedure. Also, tell your doctor if you take any medications, supplements, or herbal remedies.
Tell your doctor if you’ve had any prior scrotal surgery.
Arrange for an adult family member or friend to give you a ride home after surgery.
Shower and clean your scrotum the day of surgery. Your doctor may also ask you to shave your scrotum.
Bring an athletic supporter (jock strap) or pair of snug cotton briefs to the doctor’s office or hospital.
Eat no more than a light snack before surgery.

During Surgery

The entire procedure usually lasts less than 30 minutes.

You’ll be asked to undress and lie on a table.
You may be given medication to help you relax. To prevent pain during surgery, you’ll be given an injection of local anesthetic in your scrotum or lower groin.
Once the area is numb, one or two small incisions are made in the scrotum. This may be done with a scalpel or with a pointed clamp (no-scalpel method).
The vas deferens are lifted through the incision and cut. The ends of the vas are then sealed off using one of several methods.
If needed, the incision is closed with stitches.
You can rest for a while until you’re ready to go home.

Recovering at Home

To avoid complications, take it easy for the first few days after surgery.

For about a week, your scrotum may look bruised and slightly swollen. You may also have a small amount of bloody discharge from the incision. This is normal.

To help make your recovery more comfortable, follow the tips below.

Stay off your feet as much as possible for the first 2 days. Try to lie flat on a bed or sofa.
Wear an athletic supporter or snug cotton briefs for support.
Reduce swelling by placing an ice pack or bag of frozen peas in a thin towel. Then place the towel on your scrotum.
Take medications with acetaminophen (such as Tylenol) to relieve any discomfort. Don’t use aspirin, ibuprofen, or naproxen.
Wait 48 hours before bathing.
Avoid heavy lifting or exercise for 7 days.
Ask your doctor how long to wait before having sex again. Remember: You must use another form of birth control until you’re completely sterile.

Sex After Vasectomy

Vasectomy doesn’t change your sexual function. So when you start having sex again, it should feel the same as before. A vasectomy also shouldn’t affect your relationship with your partner. It’s important to remember, though, that you won’t become sterile right away. It will take time before you can have sex without the need for birth control.

Until you’re sterile: After a vasectomy, some active sperm still remain in your semen. It will take time and many ejaculations before the sperm are completely gone. During this period, you must use another birth control method to prevent pregnancy. To make sure no sperm are left in your semen, you’ll need to have one or more semen exams. You usually collect a semen sample at home and bring it to a lab. The sample is then checked under a microscope. You’re sterile only when these samples show no evidence of sperm. Ask your doctor whether additional follow-up is needed.
After you’re sterile: After your doctor tells you you’re sterile, you no longer need to use any form of birth control. You’re free to have sex without the fear of unwanted pregnancy. However, a vasectomy does not protect you from sexually transmitted diseases (STDs). If you have more than one sex partner, be sure to practice safer sex by using condoms.

Call your doctor if you notice any of the following after surgery:

Increasing pain or swelling in your scrotum
A large black-and-blue area, or a growing lump
Fever or chills
Increasing redness or drainage of the incision
Trouble urinating

Intravenous Pyelogram (IVP)

An intravenous pyelogram (IVP) is an x-ray exam of your urinary tract (kidneys, ureters, and bladder). This test can help find stones or other problems with your urinary tract.

Before Your Test

Follow all instructions on what to eat and drink before the test.
If instructed, take a laxative the night before your IVP.

During Your Test

You will be given an intravenous (IV) injection of contrast (a liquid that improves x-ray images).
You’ll be asked to move from side to side and then hold still as x-rays are taken.
Pressure may be applied to your belly to help get the best images.
You may be asked to empty your bladder before the final x-ray.

For your safety, the technologist needs to know about any of the following:

Allergies
Previous kidney or bladder problems
Diabetes medication you take
Any previous surgery
If you are or may be pregnant

Your Test Results

Your doctor will discuss the test results with you during a follow-up visit or over the phone.

Shock Wave Lithotripsy

Passing a kidney stone can be very painful. Shock wave lithotripsy is a treatment that helps by breaking the kidney stone into smaller pieces that are easier to pass. This treatment is also called extracorporeal shock wave lithotripsy (ESWL). Lithotripsy takes about an hour. It’s done in a hospital, lithotripsy center, or mobile lithotripsy van. You will likely go home the same day.

During the Procedure

You receive medication to prevent pain and help you relax or sleep during lithotripsy. Once this takes effect, the procedure will start.
A stent (flexible tube with holes in it) may be placed into your ureter (the tube that connects the kidney and the bladder). This helps keep urine flowing from the kidney.
Your healthcare provider then uses x-ray or ultrasound to find the exact location of the kidney stone.
Sound waves are aimed at the stone and sent at high speed. If you’re awake, you may feel a tapping as they pass through your body.

After the Procedure

You’ll be monitored in a recovery room for about 1-3 hours. Antibiotics and pain medication may be prescribed before you leave.
You’ll have a follow-up visit in a few weeks. If you received a stent, it will be removed. Your doctor will also check for pieces of stone. If large pieces remain, you may need a second lithotripsy or another procedure.

Passing the Stone

It can take a day to several weeks for the pieces of stone to leave your body. Drink plenty of liquids to help flush your system. During this time:

Your urine may be cloudy or slightly bloody. You may even see small pieces of stone.
You may have a slight fever and some pain. Take prescribed or over-the-counter pain medication as instructed by your healthcare provider.
You may be asked to strain your urine to collect some stone particles. These will be studied in the lab.

Possible Risks and Complications

Infection.
Bleeding in the kidney.
Bruising of the kidney or skin.
Obstruction (blockage) of the ureter.
Failure to break up the stone (other procedures may be needed).

Call Your Doctor If You Have:

Fever over 101°F.
Heavy bleeding.
Pain that doesn’t go away with medication.
Upset stomach and vomiting
Problems urinating.

Ureteral Stents

A ureteral stent is a soft plastic tube with holes in it. It’s temporarily inserted into a ureter to help drain urine into the bladder. One end goes in the kidney. The other end goes in the bladder. A coil on each end holds the stent in place. The stent can’t be seen from outside the body. It shouldn’t interfere with your normal routine. Your stent will be put in by a urologist (doctor trained in treating the urinary tract) or another specialist. The procedure is done in a hospital or surgery center. You’ll likely go home the same day.

When Is a Ureteral Stent Used?

A ureteral stent may be used:

To bypass a blockage in a kidney or ureter.
During kidney stone removal.
To let a ureter heal after surgery.

Before the Procedure

Your doctor will give you instructions to prepare for the procedure. X-rays or other imaging tests of your kidneys and ureters may be done beforehand.

During the Procedure

You receive medication to prevent pain and help you relax or sleep during the procedure. Once this takes effect, the procedure starts.
The doctor inserts a cystoscope (lighted instrument) through the urethra and into the bladder. This shows the opening to the ureter.
A thin wire is carefully threaded through the cystoscope, up the ureter, and into the kidney. The stent is inserted over the wire.
A fluoroscope (special x-ray machine) is used to help position the stent. When the stent is in place, the wire and cystoscope are removed.

While You Have a Stent

Some discomfort is normal. Certain movements may trigger pain or a feeling that you need to urinate. You may also feel mild soreness or pressure before or during urination. These symptoms will go away a few days after the stent is removed.
Medication to control pain or bladder spasms or to prevent infection may be prescribed. Take this as directed.
Drink plenty of fluids to help flush out your urinary tract.
Your urine may be slightly pink or red. This is due to bleeding caused by minor irritation from the stent. This may happen on and off while you have the stent.

How Long Will You Need a Stent?

The stent is often taken out after the blockage in the ureter is treated or the ureter has healed. This may take 1-2 weeks, or longer. If a stent is needed for a long time, it may need to be changed every few months.

Call Your Doctor If:

Your urine contains blood clots.
You constantly leak urine.
You have a fever over 100.4°F, chills, nausea, or vomiting.
Your pain is not relieved with medication.
The end of the stent comes out of the urethra.

During a Urodynamics Study

The study may be done in the doctor’s office, a clinic, or a hospital. Depending on which tests are being done, the study may take up to an hour or more. The tests are generally painless, so you don’t need sedating medication.

Tests That May Be Done

Uroflowmetry measures the amount and speed of urine you void from your bladder. You urinate into a funnel attached to a computer that records your urine flow over time. The amount of urine left in your bladder after you void may also be measured immediately after this test.

Cystometry evaluates how much the bladder can hold, how strong the bladder muscle is, and how well the signals work that tell you when your bladder is full. Through a catheter, your bladder is filled with sterile water or saline solution. You’re asked to report any sensations you feel and whether they’re similar to symptoms you’ve felt at home. You may be asked to cough, stand and walk, or bear down during this test.

Electromyogram helps evaluate the muscle contractions that control urination. Electrode patches or wires may be placed near the rectum or urethra to make the recording. You may be asked to try to tighten or relax your sphincter muscles during this test.

Pressure flow study measures the pressure and flow of urine out of your bladder. It is often performed after cystometry. You’re asked to urinate while a probe in the urethra measures pressures.

Video cystourethrography takes video pictures of urine flow through the urinary tract. It can help identify blockages or other problems. The bladder is filled with an x-ray contrast fluid, then x-ray video pictures are taken as the fluid is urinated out.

Getting Your Results

When the study is finished, you’ll get dressed and return to the consultation room. Test results may be available soon after the study is finished, or you may return to your doctor’s office in a few days for your results. Your doctor can talk with you about the study report and your options.

What Is a Urodynamics Study?

A urodynamics study is a series of tests that gives your doctor a detailed look at the function of your bladder and urethra. These tests can help your doctor evaluate any problems you may be having with storing urine or voiding (eliminating) urine from your body.

Understanding the Lower Urinary Tract

The lower part of the urinary tract includes the bladder (which stores urine until you’re ready to release it) and the urethra (the canal that carries urine from the bladder out of the body). Signals from the brain tell the sphincter(muscles around the opening of the bladder) when to relax and the bladder when to contract to let urine flow out of the body.

Why You Need a Urodynamics Study

Possible problems that you may have with storing or voiding urine include the following:

You may be incontinent (leak urine).
Your bladder may not empty completely.
You may have symptoms, such as the frequent need to urinate or a constant, urgent need to urinate.
Your urine stream may be intermittent or weak.
You may have persistent urinary tract infections.

Preparing for the Study

Tell your doctor which medications you’re taking, and ask whether you should stop them before the study. You may be asked to keep a diary of your urination habits for a few days before the study. This diary can be a helpful part of your evaluation. Ask whether you need to arrive for the study with a full bladder.

Cystectomy

Cystectomy is the surgical removal of the entire bladder. This surgery may be suggested in certain cases of bladder cancer, especially high-grade, high-stage cancer. Your doctor can discuss the risks and benefits of cystectomy with you. If you decide to have surgery, the surgeon can explain the procedure and answer your questions.

Preparing for Surgery

You’ll be given instructions on how to prepare for your surgery. These may include the following:

Your doctor may advise donating your own blood before surgery in case you need a transfusion during the procedure.
You may be given antibiotics to take before surgery to help prevent infection.
Don’t eat or drink anything after midnight the night before surgery.
You may be given a special drink to help clear out your intestine. In some cases, you may be admitted to the hospital the night before surgery and given medications and enemas to empty the intestine.

Removing the Bladder

The surgery is done in the hospital. It generally takes 4-6 hours, but can take longer depending on the situation. You’ll be given general anesthesia so you sleep throughout the procedure. An incision is made near your bellybutton. The area around your bladder is examined to see if the cancer has spread. If it has, the procedure may not be continued. If the cancer is only in the bladder, the bladder is removed. In case cancer cells have already spread, other organs near the bladder are often removed as well.

Creating a New Path for Urine

When the bladder is removed, another way to store and release urine is needed. This often means making a new opening for urine to travel out of the body. This procedure is called a urostomy. Your doctor will explain this procedure to you.

Risks and Possible Complications

Infection.
Bleeding, requiring a transfusion.
Blockage of intestine.
Impotence.
Blood clot.

Cystoscopy

Cystoscopy is a procedure that lets your doctor look directly inside your urethra and bladder. It can be used to:

Help diagnose a problem with your urethra, bladder, or kidneys.
Take a sample (biopsy) of bladder or urethral tissue.
Treat certain problems (such as removing kidney stones).
Place a stent to bypass an obstruction.
Take special x-rays of the kidneys.

Based on the findings, your doctor may recommend other tests or treatments.

What Is a Cystoscope?

A cystoscope is a telescope-like instrument that contains lenses and fiberoptics (small glass wires that make bright light). The cystoscope may be straight and rigid, or flexible to bend around curves in the urethra. The doctor may look directly into the cystoscope, or project the image onto a monitor.

Getting Ready

To prepare, stop taking any medications as instructed. Ask whether you should avoid eating or drinking anything after midnight before the procedure. Follow any other instructions your doctor gives you.

The Procedure

Cystoscopy is done in the doctor’s office or hospital. The doctor and sometimes a nurse are present during the procedure. It takes only a few minutes, longer if a biopsy, x-ray, or treatment needs to be done. During the procedure:

You lie on an exam table on your back, knees bent and legs apart. You are covered with a drape.
Your urethra and the area around it are washed. Anesthetic jelly may be applied to numb the urethra. Other pain medication is usually not needed. In some cases, you may be offered a mild sedative to help you relax. If a more extensive procedure is to be done, such as a biopsy or kidney stone removal, general anesthesia may be needed.
The cystoscope is inserted. A sterile fluid is put into the bladder to expand it. You may feel pressure from this fluid.
When the procedure is done, the cystoscope is removed.

After the Procedure

If you had a sedative, general anesthesia, or spinal anesthesia, you must have someone drive you home. Once you’re home:

Drink plenty of fluids.
You may have burning or light bleeding when you urinate-this is normal.
Medications may be prescribed to ease any discomfort or prevent infection. Take these as directed.
Call your doctor if you have heavy bleeding or blood clots, burning that lasts more than a day, a fever over 101°F , or trouble urinating.

Tell your doctor before the exam if you:

Take any medications, such as aspirin or blood thinners.
Have allergies to any medications.
Are pregnant.

Cystography (Retrograde)

Cystography (also called retrograde cystography) is an exam of the bladder using x-rays. This test is done by a radiologist, a doctor who specializes in the use of x-ray imaging to diagnose and treat health conditions. During a cystography, the bladder is filled with a special contrast medium(x-ray dye) or radioactive medium (radionuclide). This medium ensures more detailed x-ray pictures.

Why Cystography Is Done

A cystography can help diagnose such bladder problems as:

Stones.
Lesions or ruptures of the bladder wall.
Urinary tract infection.
Blood clots.
Tumors.

Preparing for the Procedure

Tell the radiologist if you have any allergies to contrast medium. Also mention if you have a current bladder infection or are pregnant.
If instructed, use a laxative or an enema to empty your bowel before the exam.
Empty your bladder before the exam.
Follow any other instructions you are given.

During the Procedure

You will change into a hospital gown and lie on an exam table. Your urethra will be numbed with an anesthetic jelly. You may also be given medication to help you relax.
A catheter (thin tube) will be inserted into the urethra up to the bladder. You will feel pressure. The dye or medium is injected through the catheter into the bladder. As your bladder fills with this liquid, you will feel the urge to urinate. Tell the radiologist when the urge becomes uncomfortable.
The catheter is removed. X-rays are taken of the full bladder. The bladder is then drained and more x-rays are taken.

After the Procedure

You may feel some burning during urination for a few hours after the test. Drink plenty of water after the procedure to help dilute your urine.
Your doctor will discuss your test results with you and recommend further testing or treatment.

Potential Risks and Complications Include

Infection or bruising around the catheter insertion site.
Problems due to contrast medium, including allergic reaction or kidney damage.
Radiation exposure to reproductive organs.

Call your doctor after the procedure if you notice:

Blood in your urine after three urinations.
Signs of infection, including chills, fever, increased heart rate, and fast breathing.

Transrectal Ultrasound and Biopsy

Ultrasound is an imaging test. It uses sound waves to form pictures of your organs that appear on a screen. Transrectal ultrasound uses a special probe that is placed directly into the rectum. This test lets your doctor assess the prostate gland, which is in front of your rectum. During the test, tissue samples (biopsy) may also be taken.

Preparing for Your Test

You may be asked to clear your bowel before the test. This is done with an enema or by drinking a special liquid.
You may be asked not to eat or drink anything after midnight the night before the test.
Tell the sonographer (specially trained technologist who does the test) what medications you take. Answer any other questions the sonographer asks about your medical history. Your answers will help the sonographer tailor the test to your health needs.

During Your Test

You may be asked to change into a gown. You will then lie on your side on an exam table, with your knees bent.
The test is done with a hand-held probe (transducer). This is a short, slender rod. It is covered with a sterile sheath and non-greasy gel. It is then gently placed inside the rectum.
You will feel pressure from the probe. If you feel pain, let the sonographer know.
If a biopsy is taken, it is done using a small probe with a very tiny needle on the end. This needle enters the prostate and removes several tiny samples of tissue. These samples are then sent to a lab to be examined.

After the Test

Before leaving, you may need to wait for a short time while the images are reviewed. In most cases, you can go back to your normal routine after the test. If you had a biopsy, you may notice some blood in your urine or stool for a day or so. This is normal. Your doctor will let you know when the results of your test are ready. Be aware that although the sonographer can answer questions about the test, only a doctor can explain the results.

Call your doctor if:

You have very bloody urine or stool.
You develop a fever over 100.4°F (38°C) after the test.

Adult Circumcision

Circumcision is a procedure to remove the foreskin, the loose fold of skin that covers the head of the penis. You may have a condition that requires circumcision. Or, you may want to be circumcised for personal reasons. Either way, you will want to know what to expect. Read on to learn more about adult circumcision and how it’s done.

Before the Procedure

Tell your doctor about all medications you take and any allergies you have. Cream to numb the skin of the penis may be applied 30 to 60 minutes before the procedure. Also, there will be some swelling and soreness after the procedure, so arrange for an adult family member or friend to drive you home.

During the Procedure

The penis and surrounding area are cleaned and prepared for the procedure.
An intravenous (IV) line is placed in your hand or arm. It supplies fluids and medication. This may include medication (anesthesia) to prevent pain. Depending on what type of anesthesia you get, you may be awake, drowsy, or asleep during the procedure. Either way, the skin of the penis may be numbed with injections of local anesthesia.
Once the penis is numb or you are drowsy or asleep, incisions are made in the foreskin. The foreskin is then removed.
The incisions are closed with sutures (stitches) or surgical glue.
Pressure is applied to stop any bleeding, if necessary.
The incision is covered with ointment and a bandage is put on the penis.

After the Procedure

You will be taken to a recovery area where you’ll recover from the anesthesia. Nurses will check on you as you rest. They can also give you pain medication if needed. Your doctor will tell you when it’s okay for you to go home. This will be the same day. When you dress to go home, wear snug-fitting, brief-style underwear. This will help hold your bandage in place. You will also be given care instructions for when you return home.

What to Expect

You will probably see a crust of blood or yellowish coating around the head of the penis. Do not remove scabs. It’s okay if they fall off on their own.
The penis will swell. It may bleed a little around the incision.
The head of the penis will be red or black-and-blue.
You may have pain with urination for the first few days.
Take pain medication as instructed by your healthcare provider.
Healing takes about 2 weeks. The stitches should dissolve on their own.

Caring for Your Penis

You may shower 24 hours after surgery. When drying off, gently pat the penis dry.
Don’t take a bath or use a hot tub, Jacuzzi, or swimming pool for 2 weeks after surgery.
Follow your healthcare provider’s instructions for bandage care. Change or remove the bandage only when told to do so by your healthcare provider. This will likely be the day after surgery.
Avoid all sexual activity for 4-6 weeks after surgery. An erection can cause the incisions to open. Ask your healthcare provider what you can do to help stop erections.

Follow-Up

Make a follow-up appointment as directed by our staff.

Call the healthcare provider right away if you have any of the following:

Fever of 100.4°F or higher.
Increased redness, bruising, or swelling of the penis.
Discharge that is heavy, a greenish color, or lasts more than a week.
Bleeding that isn’t controlled by applying gentle pressure.
Inability to urinate.

Stress Urinary Incontinence: Having Laparoscopic Retropubic Suspension Surgery

To help treat stress urinary incontinence (SUI), your surgeon may perform a procedure called retropubic suspension. This surgery is done laparoscopically-that means through small incisions in the belly. During the surgery, sutures are used to firmly support the pelvic organs and help prevent urine leakage. Your surgery will take about 2 hour(s). You will be asked to do some things at home to prepare for surgery. Below are guidelines to help you get ready. If you have any questions, call your nurse or doctor.

The Weeks Before Surgery

Tell your doctor about aspirin and other medications, vitamins, or herbs you take. Ask if you should stop taking them before surgery.
Stop smoking to help reduce your risks during surgery.
If you have been given any prescriptions to fill, do this before surgery.

The Night Before Surgery

You may be asked to give yourself an enema. This cleans out your bowels for surgery. You’ll be told how to do it.
Do not eat, drink, or chew anything after the midnight before surgery, as instructed. This includes water and chewing gum. But if you’ve been told to take any medications, swallow them with small sips of water.

The Day of Surgery

Arrive at the hospital a few hours before surgery as directed. Have someone drive you there who can also stay during the surgery, and drive you home. At the hospital, your temperature and blood pressure will be taken. In some cases, tests may be done. Then, you will receive one or more IV (intravenous) lines. These lines give you fluids and medications before, during, and after surgery. Some of your pubic hair may be removed. Tight stockings may be put on your legs to help prevent blood clots.

About Anesthesia

To keep you pain-free during surgery, you’ll receive anesthesia. General anesthesia allows you to sleep. Regional anesthesia numbs the lower part of your body. Local anesthesia numbs the area that will be operated on. Before surgery, you’ll meet with the anesthesiologist or nurse anesthetist. He or she can tell you what kind of anesthesia you will receive and answer questions you may have.

During the Procedure

Small incisions are made in the belly.
A laparoscope (a thin, telescope-like tool) is put into the belly through one of the incisions. This lets the surgeon look inside your body.
The surgeon performs the surgery through the other small incisions. Sutures (stitches) are put through the tissue next to the vagina to help support the urethra and bladder firmly in place. This helps keep the urethra closed to prevent urine leakage.
The incisions are closed with sutures, staples, or strips of tape (Steri-Strips).

Risks and Complications

The risks and complications of this procedure may include:

Infection.
Bleeding.
Risks of anesthesia.
Blood clots.
Damage to nerves, muscles, bladder, or nearby pelvic structures.
Difficulty urinating.
Urinary urgency.

Stress Urinary Incontinence: Having Retropubic Suspension Surgery

To help treat stress urinary incontinence (SUI), your surgeon may perform a procedure called retropubic suspension. It is done by making an incision in the lower part of your belly (abdomen). During this surgery, the surgeon puts sutures (stitches) through the tissue next to the vagina to help support the urethra and bladder firmly in place. This helps keep the urethra closed to prevent urine leakage. Your surgery will take about 2 hour(s). You will be asked to do some things at home to prepare for surgery. Below are guidelines to help you get ready. If you have any questions, call your nurse or doctor.

The Weeks Before Surgery

Have any tests that your doctor orders.
Tell your doctor about aspirin and other medications, vitamins, or herbs you take. Ask if you should stop taking them before surgery.
Stop smoking to help reduce your risks during surgery.
If you have been given any prescriptions to fill, do this before surgery.

The Night Before Surgery

You may be asked to give yourself an enema. This cleans out your bowels for surgery. You’ll be told how to do it.
Do not eat, drink, or chew anything after the midnight before surgery, as instructed. This includes water and chewing gum. But if you’ve been told to take any medications, swallow them with small sips of water.

The Day of Surgery

About Anesthesia

During the Procedure

An incision about 4 inches long is made in the lower part of the abdomen, near the pubic hairline.
Through the incision, the surgeon places sutures into the tissue next to the vagina. Or sutures may be placed into the outside walls of the vagina behind the urethra. The ends of the sutures are tied to strong tissues or bone nearby.
The incision is closed with sutures, staples, or strips of tape (Steri-Strips).

Risks and Complications

The risks and complications of this procedure may include:

Infection.
Bleeding.
Risks of anesthesia.
Blood clots.
Damage to nerves, muscles, bladder, or nearby pelvic structures.
Difficulty urinating.
Urinary urgency.

Stress Urinary Incontinence: Having Pubovaginal Sling Surgery

To help treat stress urinary incontinence (SUI), your surgeon may perform a procedure called pubovaginal sling surgery. A “sling” of tissue is placed like a hammock under the bladder and urethra. The sling helps support the bladder and urethra firmly in place. This helps keep the urethra closed to prevent urine leakage. Your surgery will take about 2 hour(s). You will be asked to do some things at home to prepare for surgery. Below are guidelines to help you get ready. If you have any questions, call your nurse or doctor.

The Weeks Before Surgery

Have any tests that your doctor orders.
Tell your doctor about aspirin and other medications, vitamins, or herbs you take. Ask if you should stop taking them before surgery.
Stop smoking to help reduce your risks during surgery.
If you have been given any prescriptions to fill, do this before surgery.

The Night Before Surgery

You may be asked to give yourself an enema. This cleans out your bowels for surgery. You’ll be told how to do it.
Do not eat, drink, or chew anything after the midnight before surgery, as instructed. This includes water and chewing gum. But if you’ve been told to take any medications, swallow them with small sips of water.

The Day of Surgery

About Anesthesia

During the Procedure

An incision 2 to 4 inches long is made in the lower part of your belly (abdomen), near the pubic hairline. A second small incision is made in the front wall of the vagina.
If tissue from your body is used for the sling, it may be taken from your abdomen or thigh. If synthetic material or donor tissue is used, it is cut to the right size.
Working through both incisions, the surgeon places the sling under the bladder and urethra. The ends of the sling are secured to strong tissues in your abdomen.
The incision in the abdomen is closed with sutures (stitches), staples, or strips of tape (Steri-Strips). The vaginal incision is closed with sutures. Once this incision has healed, it should not cause you problems during sex.

Risks and Complications

The risks and complications of this procedure may include:

Infection.
Bleeding.
Risks of anesthesia.
Blood clots.
Damage to nerves, muscles, bladder, or nearby pelvic structures.
Difficulty urinating.
Urinary urgency.

Stress Urinary Incontinence: Having Tension-free Vaginal Sling Surgery

To help treat stress urinary incontinence (SUI), your surgeon may perform a procedure called tension-free vaginal sling surgery. A “sling” of tissue is placed under the urethra. The sling (tape) is made from synthetic (manmade) material. When the tension of the tape is adjusted, urine should no longer leak. Your surgery will take about 60 minutes. You will be asked to do some things at home to prepare for surgery. Below are guidelines to help you get ready. If you have any questions, call your nurse or doctor.

The Weeks Before Surgery

Have any tests that your doctor orders.
Tell your doctor about aspirin and other medications, vitamins, or herbs you take. Ask if you should stop taking them before surgery.
Stop smoking to help reduce your risks during surgery.
If you have been given any prescriptions to fill, do this before surgery.

The Night Before Surgery

You may be asked to give yourself an enema. This cleans out your bowels for surgery. You’ll be told how to do it.
Do not eat, drink, or chew anything after the midnight before surgery, as instructed. This includes water and chewing gum. But if you’ve been told to take any medications, swallow them with small sips of water.

The Day of Surgery

About Anesthesia

To keep you pain-free during surgery, you’ll receive anesthesia. General anesthesia allows you to sleep. Local anesthesia numbs the area that will be operated on. Before surgery, you’ll meet with the anesthesiologist or nurse anesthetist. He or she can tell you what kind of anesthesia you will receive and answer questions you may have.

During the Procedure

Two small incisions are made in the lower part of the abdomen (belly), near the pubic hairline. Another small incision is made in the front wall of the vagina.
Working through the incisions, the surgeon places the tape like a hammock under the urethra. The two ends of the tape emerge through the abdominal incisions.
If you’re given local anesthesia, your surgeon may tell you to cough so that the tension of the tape can be adjusted.
When the tension is adjusted, the ends of the tape are cut and remain below the skin in the tissue of the abdominal wall. The healing process of the incisions holds the ends of the tape in place.
The incisions in the abdomen and vagina are closed with sutures (stitches).

Risks and Complications

The risks and complications of this procedure may include:

Infection.
Bleeding.
Risks of anesthesia.
Blood clots.
Damage to nerves, muscles, bladder, or nearby pelvic structures.
Difficulty urinating.
Urinary urgency.

Urostomy: Caring for Your Stoma

After a urostomy, you’ll have to care for your stoma and the skin around it (peristomal skin). You must keep the stoma clean and protect the peristomal skin from moisture and urine. This is to prevent skin problems and odor.

Checking the Stoma

Check your stoma and the skin around it each time you change your pouch.
Stand in front of a mirror, or use a hand mirror so that you can see the entire stoma.
The stoma should look shiny, moist, and pink or red.
The skin around it should be smooth, with no red or broken spots.

Cleaning the Stoma

When you change your pouch, be sure to clean the stoma and the skin around it. Do this using warm water and a soft washcloth. Water does not harm the stoma.

Clean and dry the stoma gently. Because the stoma has no sensory nerves, you could injure it without feeling any pain.
The stoma may bleed a little when you clean it. That’s because it has tiny blood vessels. To stop the bleeding quickly, apply gentle pressure to the stoma using a dry cloth or tissue.
Be aware that urine will keep flowing out as you clean your stoma. You can use a folded paper towel or piece of gauze to absorb the urine.

Protect the Skin Around the Stoma

For the pouch to stick well, the peristomal skin needs to be dry and smooth. If the skin is moist or uneven, the pouch is more likely to leak. And any urine that leaks out of the pouch can pool on your skin. This can irritate the skin. Urine that leaks from the pouch can also cause odor or be absorbed by your clothes. You can help prevent these problems by following these steps:

Be sure your skin is dry before applying the skin barrier. This helps keep the skin healthy. Always pat your skin dry after washing it. Or, try drying your skin with a hair dryer that’s set on “cool.”
Try applying a skin barrier wipe before you put on a new pouch. This helps protect the skin if urine leaks around the pouch. A skin barrier wipe may shorten or lengthen the amount of time you can wear some pouches. Before using a wipe, check the product information enclosed with your pouch.

Call Your WOC Nurse or Other Healthcare Provider If:

The skin around the stoma is red, weepy, bleeding, or broken.
The skin around the stoma itches, burns, stings, or has white spots.
The stoma swells, changes color, or bleeds without stopping.
The stoma sinks below its normal level or below the skin.
The stoma sticks up above the skin more than normal.

Urostomy: Changing Your Pouch

You’ve just had a urostomy. As part of your surgery, a small opening (stoma) was made on the abdomen. Urine and mucus drain from the stoma into a disposable pouch. You’ll be shown how to change your pouch before you leave the hospital. Plan to replace your pouch every few days. And change it early in the morning, when your urine output is less. To change your pouch, follow the steps below.

How to Change Your Pouch

Step 1: Prepare the new pouch.

Gather your supplies in the bathroom. These include plastic bags, toilet tissue, paper towels or a soft washcloth, a clean cloth or towel, an extra skin barrier wipe (if desired), and a new pouch.
If you don’t use a pouch with a precut skin barrier, size and cut the opening now.
Slowly peel the backing off the skin barrier. Set the skin barrier aside.
Empty the used pouch before removing it. When you empty the pouch, be sure to sit on the toilet. Or, stand in front of the toilet.

Step 2: Remove the used pouch.

When removing the used pouch, sit on the toilet. Or, stand in front of the toilet.
Carefully push the skin away from the skin barrier with one hand. Do this starting at the upper edge of the barrier. With the other hand, slowly peel the skin barrier off from top to bottom.
Seal the used pouch in a plastic bag. Then throw it away in a trash bin.

Step 3: Clean around the stoma.

Use toilet paper to wipe urine or mucus from the stoma or from the skin around it.
Clean the skin with warm water and a soft washcloth or paper towel. Wash right up to the edge of the stoma. You can also do this when you shower.
Pat the skin dry with a clean towel.

Step 4: Put on the new pouch.

Use a folded paper towel or a piece of gauze to keep your stoma dry while you’re putting on the new pouch.
Using one hand, pull the skin on your abdomen tight to smooth out any wrinkles. Place the barrier over the stoma.
Starting from the bottom of your stoma, apply the skin barrier. Put the palm of your hand over the barrier. Hold the barrier in place for 45 seconds. This molds it to your skin.
If you use a two-piece pouch, snap the pouch onto the skin barrier. Start at the bottom and work your fingers around the barrier.
Make sure the pouch drain is in the “closed” position. If this pouch has a drain cap, be sure to close it.
After you change the pouch, wash your hands.

Call Your WOC Nurse or Other Healthcare Provider If:

The skin around the stoma is red, weepy, bleeding, or broken.
The skin around the stoma itches, burns, stings, or has white spots.
The stoma swells, changes color, or bleeds without stopping.
The stoma sinks below its normal level or below the skin.
The stoma sticks up above the skin more than normal.

Urostomy: Emptying Your Pouch

You’ve just had a urostomy. As part of your surgery, a small opening (stoma) was made on the abdomen. Urine and mucus drain from the stoma into a disposable pouch. You’ll need to empty your pouch regularly when it gets to be about one-third full. The pouch is likely to become this full every 2 to 3 hours. Emptying your pouch keeps the pouch from bulging under your clothes. It also helps prevent leakage and odor. To empty your pouch, follow the steps below.

How to Empty Your Pouch

Step 1: Empty the pouch.

Sit on the toilet. Or, stand in front of the toilet. Put a layer of toilet paper in the toilet bowl to keep urine from splashing.
Pull your clothes away from the pouch.
Hold the pouch drain over the toilet bowl.
Open the pouch drain so that urine flows into the toilet.
Empty all the urine and mucus from the pouch. While holding the pouch with one hand, slide the fingers of your other hand down the pouch. This will help empty any mucus from the pouch.

Step 2: Close the pouch drain.

Once you’ve emptied the pouch, use a piece of toilet paper to dry the tip of the drain. This will keep any urine or mucus from getting on your clothes.
Put the pouch drain in the “closed” position. This may prevent leaking and odor.
Wash your hands after emptying the pouch.

Urostomy: Maintaining Your Health

You’ve just had a urostomy to provide a new way for urine to drain from your body. Follow the tips on this sheet to learn how to maintain your health and help prevent problems.

A Few Words on Diet

When you are active, be sure to drink extra water. You don’t have to follow a special diet after your urostomy. There’s also no need to avoid any foods. But be aware that asparagus and some other foods may cause your urine to smell.

Drinking Plenty of Water

Drink at least 8 glasses of water a day, unless your doctor has advised you to drink less fluid. Drinking plenty of water will help prevent urine odor and dehydration (when too much fluid is lost from the body).
If you become dehydrated, less urine will flow from your stoma. You may feel thirsty and tired. And your skin and mucous membranes may get dry. You may also get stomach cramps.
If you do get dehydrated, drink plenty of fluids.
Call your healthcare provider if you can’t keep fluids down because of nausea or vomiting.

Taking a Shower or Bath

You can take a shower or bath with or without your pouch.
If you bathe without your pouch, you may want to do this in the morning. This is when your urine output is less.
At other times of the day, showering is a better option than bathing. That way, any urine that flows from your stoma will run down the drain.

When You Have a Checkup

After a urostomy, you may need to visit your healthcare provider every few months at first. After that, your stoma should be checked once a year.
Any time your healthcare provider needs a urine sample, he or she should take it from your stoma. This will be done with a special catheter. Do not take a urine sample from your pouch.
When you visit your healthcare provider, bring extra supplies in case you need to change your pouch.
Always let your healthcare provider know right away about any problems with your urinary tract or stoma.

If You Have Symptoms of a Urinary Tract Infection

Call your WOC nurse or other healthcare provider if you have any of the following symptoms of a urinary tract infection:

Fever or chills.
Kidney pain.
Blood in your urine.
Cloudy or foul-smelling urine for more than a week.

Getting Support

Adjusting to a urostomy takes time. But your family and friends can help you. Your surgeon, WOC nurse, and other healthcare providers are there to answer your questions, too. And they can help you find a support group. This is a group of people who share similar concerns or problems. You can also contact the organizations listed below:

Urostomy: Managing Skin Problems

You’ve just had a urostomy. As part of your surgery, a small opening (stoma) was made on the abdomen. Taking good care of the skin around the stoma is very important to prevent skin problems. If a problem does occur, you need to know what to do. Listed below are some of the most common skin problems and steps you can take to manage them. If any of these problems lasts more than a week, call your WOC nurse or other healthcare provider. If your pouch leaks, use a measuring guide to check that the pouch opening is the correct size.

Common Skin Problems

A leaking pouch can make the skin red and weepy. This may be caused by a pouch with an opening that is too big or too small. Use a measuring guide to check that the opening on the pouch is the correct size.
Allergies to skin barriers can make the skin itch, burn, or sting. You may need to try a new skin barrier or change to a new kind of pouch.
Yeast infections can make the skin red and itchy. These infections are more likely to occur if there’s sweat under the pouch. A pouch cover can help keep the skin beyond the skin barrier dry. You may need to ask your WOC nurse or other healthcare provider about using antifungal products.
Urine pooling on the skin can make the skin look waterlogged. To prevent this, make sure your pouch fits well. Dry your skin thoroughly before you put on a new pouch.
Hair under the pouch can make the skin inflamed. To avoid this, shave off any hair around the stoma with an electric razor. Always shave away from the stoma.
Urine can crystallize, forming patches of dried urine on the stoma. To prevent this, put a washcloth soaked in equal parts vinegar and water on your stoma for a few minutes. Do this each time you change your pouch.

Urostomy: Selecting Your Pouch

After a urostomy, urine drains into a disposable pouch. The pouch sticks to the skin around the stoma. An adhesive skin barrier holds the pouch in place. This barrier also protects the skin and prevents leakage. Most pouches are made of lightweight, odorproof plastic and lie flat against the body.

Types of Pouches

There are many styles of pouches. Your WOC nurse or other healthcare provider will help you select the one that’s best for you. The skin barrier has to fit around the stoma without touching it. The barrier must stick well to prevent leakage or odor from the pouch.

One-Piece Drainable Pouch

The skin barrier and pouch come as one piece. The skin barrier holds the pouch onto the skin.
Urine is emptied from the bottom of the pouch through a drain. The drain can be opened and tightly closed. Drain styles differ, depending on the pouch selected.

Two-Piece Drainable Pouch

The skin barrier and pouch are separate pieces. The skin barrier is applied to the skin. The pouch snaps onto the skin barrier.
Urine is emptied from the bottom of the pouch through a drain. The drain can be opened and tightly closed. Drain styles differ, depending on the pouch selected.

Sizing the Stoma Opening

For the pouch to fit around the stoma, the opening of the skin barrier must be the right size. Some openings are precut, and others must be measured and cut. To find the correct size for your stoma, use a measuring guide. Most pouches come with a guide in the box. Your healthcare provider may also give you one.

Find the smallest hole on the guide that fits around the stoma without touching it. There should be about 1/8″ between the stoma and the hole on the guide.
To cut the opening yourself, center the guide hole on the back of the skin barrier. Trace the pattern. Then cut the opening using curved scissors.
For precut openings, order pouches with the sized openings that match the size of the hole on the measuring guide.

Pouch Accessories

You can buy other stoma care products through special catalogs, at medical supply stores, on the Internet, and at some drugstores.

Powders and wipes add an extra layer of skin barrier. They also help protect irritated skin.
Stoma paste and skin barrier wafers fill in uneven places in the skin around the stoma. This helps the pouch stick better.
Convex skin barriers help make a better seal. They are used if the skin around the stoma is uneven or the stoma is level with or sinks below the skin. Some convex barriers come with a pouch attached. Others are inserts that can be added to any pouch.
Pouch filters and deodorants help prevent odor.
Ostomy belts help keep the pouch in place.
Pouch covers help keep the skin under the pouch dry and comfortable.
A night drainage system lets you sleep all night without emptying your pouch. This system can also help prevent urine from pooling around the stoma, which leads to infection.

Urostomy: Using a Night Drainage System

You’ve just had a urostomy. As part of your surgery, a small opening (stoma) was made on the abdomen. Urine and mucus drain from the stoma into a disposable pouch. A night drainage system can be attached to the pouch before you go to bed. This system then collects and stores urine. That way, you can sleep all night without getting up to empty the pouch.

Parts of a Night Drainage System

The parts of a night drainage system are shown above. Some people use a catheter (tube) drainage bag to collect and store the urine overnight. Talk with your WOC nurse or other healthcare provider about what will work best for you.

Setting Up the Night Drainage System

There are several types of night drainage systems. Whichever type you chose, you need to set up the system before connecting it to the pouch. Be sure to do the following:

The tubing and the container can come as one piece. But they can also come as two pieces. If they do, put one end of the tubing into the lid of the container. Keep connected until the container must be replaced.
Each night, connect the other end of the tubing to your pouch.
You may also need an adapter to do this. Most pouches come with such adapters. If you use an adapter, place it on the tubing. Keep the adapter connected until the container must be replaced.
Replace the container when it starts to look cloudy or changes color.

At Night

The pouch should be about one-fourth full when you attach the drainage system to it at night. This will help urine flow into the tubing from the pouch. To attach the system to your pouch:

Place the night drainage container in a basin on the floor next to your bed.
Connect the tubing to the pouch.
Open the closure on the pouch drain. This way, urine can flow through the tubing.
Use a leg strap to keep the tubing next to your thigh. This will help prevent the tubing or pouch from twisting.

In the Morning

To detach the night drainage system from the pouch each morning:

Return the pouch drain to the “closed” position to prevent leakage.
Remove the lid from the night drainage container (but keep the tubing in place).
Empty the night drainage container’s contents into the toilet.
Rinse out the tubing and container with cool water in the bathroom sink or tub.

Cleaning the System

Clean the night drainage system every 2 to 3 days. Follow these steps:

Set white vinegar, a measuring cup, and a funnel next to the bathroom sink or tub.
Pour 1/4 cup vinegar through the tubing into the night drainage container.
Pour 2 cups cool water through the tubing into the container.
Let the tubing and container sit for at least 1 hour. Then, empty the contents into the toilet.
Rinse out the tubing and container with cool water.
Let the tubing and container air-dry.

What Is a Urostomy?

Urostomy is surgery that provides a new way for the body to release urine (waste fluid). It is done when the bladder is diseased or damaged. During the surgery, the surgeon brings part of the urinary tract or some of the digestive tract through the abdominal wall. Urostomy can be done in any of the ways described below. In each case, a small opening (stoma) is made on the abdomen. This allows urine and mucus to pass out of the body.

The Urinary Tract

This tract rids the body of urine and is made up of many parts. They include two kidneys, two ureters, the bladder, and the urethra.

Common Types of Urostomies

These include:

An ileal conduit. This surgery makes a passage (conduit) from a segment of the ileum (last section of the small intestine). Urine leaves the body through this passage. One end of the conduit is sewn shut. The other end is brought through the abdominal wall to form a stoma. The ureters are detached from the bladder and connected to the conduit. Urine flows through the ureters and into the conduit. Urine then leaves the body through the stoma. This surgery does not change the way stool passes from the body. An ileal conduit is the most common type of urostomy.
A colon conduit. This surgery is done much like an ileal conduit. But with a colon conduit the passage is made from a piece of the colon and not the ileum. The resulting stoma is bigger, as the colon is wider than the ileum.
A ureterostomy. This surgery brings the ureters through the abdominal wall to form one or two stomas. In this case, the stoma or stomas are smaller. This is because the ureters are more slender than the ileum or the colon.

The Stoma

The stoma is an opening on the abdomen through which urine and mucus can pass. It is made by bringing the end of the ileum, the colon, or one or both ureters through the abdominal wall. This end is then turned back on itself, like a cuff.

The stoma is pink or red and moist. This is because the insides of the ileum, the colon, and the ureters are like the inside of the mouth.
The stoma shrinks to its final size 6 to 8 weeks after surgery. Then it will be round or oval. The stoma will either be flat or it will sit 1/4″ to 1/2″ above the skin.
With an ileal or a colon conduit, both urine and mucus pass through the stoma. After a ureterostomy, only urine goes through the stoma.

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