Moving from A Super Pubic to a Urostomy

As soon as I started this blog, I had a suprapubic colostomy which required me to change my catheter every other week, and after 12 years of UTIs and complications, I was offered the chance to undergo a urostomy surgery. The procedure of urostomy involves opening up the abdominal wall to redirect the flow of urine from the urinary system to the outside of the body through the creation of an abdominal wall opening. Usually, this procedure is performed when the urinary system has been damaged or when it has to be bypassed due to a disease or a condition. In my case, my bladder was dying and severely damaged.

A suprapubic cystostomy, also known as a suprapubic catheter (SPC), vesicostomy, or epicystostomy, is a surgical connection between the urinary bladder and the skin used to drain urine from the bladder in individuals with blocked urinary flow. This connection does not pass through the abdominal cavity. Urinary flow may be obstructed by prostate swelling (benign prostatic hypertrophy), traumatic disruption of the urethra, congenital urinary tract defects, or obstructions such as kidney stones passing into the urethra and cancer. It is also a common treatment for spinal cord injury patients who cannot use intermittent catheterization to empty the bladder and are unable to void due to detrusor sphincter dyssynergia. Initially, a thin tube (catheter) is placed through the skin just above the pubic bone into the bladder, often with the assistance of ultrasound imaging. This catheter remains in place for up to a month while the tissue around it scars and forms a tract (sinus) between the bladder and the body exterior. After the scar tissue formation is complete, the catheter is periodically replaced to help prevent infection.

I struggled with severe bouts of anxiety and fear when my suprapubic catheter was changed. Post Traumatic Stress Disorder is a type of mental illness that can be caused by a traumatic event. I had experienced a traumatic experience, which triggered the fear. As a consequence of my previous experiences with catheters, I have managed my fears and coped with the catheter changes with the help of my caregivers- but it wasn't always a smooth ride for me.

A urostomy is a surgical procedure that creates a new pathway for urine to exit the body. It involves making a stoma, an artificial opening in the abdominal wall, through which urine is diverted from the bladder to an external pouch or bag. This procedure is often necessary when the normal urinary system is compromised due to conditions such as bladder cancer, spinal cord injuries, or congenital disabilities. During the surgery, the surgeon disconnects the ureters from the bladder and redirects them to the stoma, allowing urine to drain directly into a pouch attached to the outside of the body.

There are two primary techniques for redirecting urine from the body in urostomy: incontinent diversion and continent diversion. Incontinent diversion, also known as standard or conventional urostomy, entails creating a stoma through the abdominal wall to enable continuous drainage of urine into an external pouch. The urinary pathway is redirected to establish a new exit point for urine. Continent diversion, also referred to as continent urinary reservoir, involves the creation of a storage space for urine within the body using a section of the intestine. Urine flow is controlled by a valve mechanism, and a stoma is made to allow access for emptying the reservoir using a catheter.

My Thoughts: This is probably the best decision I have ever made for my health in the last 12 years. The discomfort and pain that I experienced with the SP Cath was unbearable for the duration of the years that I had it. The procedure to remove the SP Cath was very straightforward and simple. I'm so glad that I did it and that it is finally over. I'm glad that I can now focus on living a healthier and happier life.

A few months later, I had my Urostomy surgery, which has helped me a great deal. I haven't had any urinary pain for the last few months, and I have found it to be a great help in my quality of life. I'm glad I had the operation and hope to continue feeling well. I'm grateful for the medical care I received and the support I received from my family and friends. Today, I only change my bag every three to four days, and I empty my bed bag once it is full.