After surgery, the patient's urine should be monitored closely. The urinary stoma, which protrudes approximately one-half inch above the skin, should be fitted with a urinary appliance. The color of the stoma should be checked frequently for several days after surgery. Normal color is deep pink to dark red, and a dusky appearance could indicate stomal necrosis. Mucus will be present in all urinary diversions constructed from bowel segments, because the intestine normally produces mucus.
Excessive mucus can clog the urinary appliance.
This problem can be minimized by increasing the patient's fluid intake to 3 liters per day. The patient should be educated in the proper skin care and pouching of the stoma. Other topics of education include handling equipment, early identification of kidney infections, community- and hospital based resources, and body image issues. Patients with a continent ileal reservoir do not have an external appliance and the catheterization of the pouch duplicates normal bladder function. These patients will need to learn self-catheterization techniques.