How often should a urostomy (urinary ostomy) bag be changed?

Urostomy Bag Changing Frequency and Care Guidelines

Urostomy bags should be changed every 5-7 days under normal circumstances, with more frequent changes needed if there is leakage, skin irritation, or pouch system failure.1

Optimal Changing Schedule

• The standard recommendation is to change urostomy bags every 5-7 days to prevent complications while minimizing unnecessary handling 1, 2
• More frequent changes may be necessary in cases of:
  • Leakage around the stoma 1
  • Peristomal skin irritation or breakdown 3
  • Pouch system failure or damage 2
  • Odor that persists despite proper cleaning 2

Proper Changing Technique

• Handle the skin carefully to minimize trauma and reduce the risk of complications 1
• Clean the peristomal skin with fresh tap water and mild soap, then thoroughly dry before applying a new appliance 1
• Ensure the opening of the appliance is cut approximately 1/8 inch larger than the stoma to prevent irritation while limiting skin exposure to urine 1
• Avoid using adhesive tapes directly on sensitive skin; consider soft silicone tapes for securing essential items 1

Preventing Leakage and Skin Complications

• Measure the stoma size at each appliance change for the first 8 weeks as the stoma may change in size during this period 1
• Use barrier films or creams containing zinc oxide to protect the peristomal skin from urine exposure 1, 3
• Consider convex appliances, ostomy belts, paste, or barrier rings for stomas that are flush with the skin or positioned in difficult locations 1
• For persistent leakage issues, foam dressings rather than gauze can help reduce skin maceration by lifting drainage away from the skin 1

Managing Peristomal Skin Problems

• Up to 80% of ostomy patients develop stoma-related skin complications, making proper care essential 3
• Clean any signs of infection promptly and consider topical antimicrobial agents if necessary 1
• For excessive granulation tissue around the stoma, consider application of a foam or silver dressing over the affected area 1
• In cases of persistent skin irritation, a healthcare provider may recommend topical corticosteroid sprays 3

Special Considerations

• Patients with urostomies have unique needs compared to other ostomy types, as urine is more caustic to the skin than fecal matter 4
• Drinking cranberry juice may help improve peristomal skin conditions in some patients, though research shows mixed results regarding its effect on urine pH 5
• For patients with persistent leakage due to peristomal indentations, specialized solutions such as silicone block insertion may be considered 6

Common Pitfalls to Avoid

• Changing the bag too frequently can lead to unnecessary skin trauma 2
• Not changing the bag frequently enough can result in leakage and skin breakdown 1
• Using adhesive removers improperly can damage sensitive peristomal skin 1
• Failing to properly measure the stoma before cutting the appliance opening can lead to exposure of peristomal skin to urine 1
• Neglecting to check the security of the pouch system before completing the change process 2