Medical Surgical Bladder cancer and cystoscopy #4

Question

A client diagnosed with bladder cancer is undergoing a ureterostomy and asks the nurse how she will urinate. Which reply from the nurse best explains a ureterostomy?

Answers

  1. “Your urine will be collected in a portion of your intestines through an opening of your skin in a pouch.”
    • Rationale:

      This answer is not correct because this describes an ileal conduit. An ileal conduit collects the urine in part of the intestines and through peristalsis, is moved out through the stoma into a pouch.

  2. “Your urine will be diverted into a surgically created pouch in which you will self catheterize.”
    • Rationale:

      This answer is not correct since self-catheterization is not involved in an ureterostomy. An ileal reservoir diverts urine into a surgically created pocket which functions as a bladder and the client removes the urine by self-catheterization.

  3. “Ureterostomies reroute urine to the large intestine and your urine will be excreted with your bowel movements.”
    • Rationale:

      This answer is not correct because ureterostomies do not allow for the excretion of urine with bowel movements. This type of surgical intervention is called a sigmoidostomy, where urine is rerouted to the large intestine and expelled with bowel movements.

  4. “Your urine will be redirected to the skin surface through an opening and be collected in a pouch.”
    • Rationale:

      This answer is correct because a ureterostomy attaches the ureters to the skin surface of the abdomen through an opening in the skin. This opening is called a stoma. The urine flows into a pouch through the stoma without a conduit.

Overview

A ureterostomy diverts urine to the skin surface through a stoma. The urine is then collected in a pouch. A ureterostomy attaches the ureters to the skin surface of the abdomen through an opening in the skin.

Explanation

Learning Outcomes

A ureterostomy attaches the ureters to the skin surface of the abdomen through an opening in the skin. This opening is called a stoma. The urine flows into a pouch through the stoma without a conduit. Possible complications include infection, skin breakdown and obstruction of urinary flow due to strictures. An ileal conduit collects urine in part of the intestines and moves it through the stomach with the aid of peristalsis, into the pouch. An ileal reservoir diverts urine into a surgically created pouch. Urine is removed from the pouch through self-catheterization. A sigmoidostomy is where urine is rerouted to the large intestine and expelled with bowel movements.

Test Taking Tip

Have comprehension of the different types of “ostomies” associated with the urinary system.

Video Rationale