Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each
HCPCS code
Name of the Procedure:
Ostomy Pouch, Urinary, with Standard Wear Barrier Attached, with Built-in Convexity (1 piece)
Common Names: Urinary Ostomy Pouch, Convex Ostomy Bag
Technical/Medical Term: HCPCS Code A4392 Ostomy Pouch
Summary
An ostomy pouch for urinary diversion is a medical device used to collect urine from a surgically created stoma—a small opening on the abdomen. The device is a one-piece system with a standard wear barrier and built-in convexity, which helps to secure the pouch and provide a better fit around the stoma.
Purpose
This device is used for individuals who have had a urostomy, a surgical procedure that creates an opening in the abdomen for urine to pass through. The ostomy pouch collects urine, helping patients manage urinary output effectively.
Indications
- Conditions warranting this device include bladder cancer, congenital defects, trauma, or severe bladder dysfunction.
- Ideal for patients who require a secure, leak-proof collection system and have a stoma that benefits from built-in convexity for a better seal.
Preparation
- Patients should follow their healthcare provider's instructions regarding diet or medication changes before use.
- No special diagnostic tests are required, but an initial consultation to ensure the correct fit and type may be necessary.
Procedure Description
- Cleaning the Stoma: Clean the stoma and surrounding area with mild soap and water, ensuring the skin is dry.
- Cutting the Barrier: Cut the barrier to fit snugly around the stoma, approximately 1/8 of an inch larger than the stoma.
- Applying the Pouch: Remove the adhesive backing and gently apply the adhesive barrier to the skin, pressing it into place to ensure a secure fit around the stoma.
- Securing the Pouch: Ensure the pouch is securely attached and there are no leaks. The built-in convexity should provide additional security for stomas requiring additional support due to their shape or location.
Duration
The application of the ostomy pouch takes about 10-15 minutes. The pouch itself can be worn for several days, depending on individual needs and wear.
Setting
This procedure can be performed at home by the patient or caregiver, or in a clinical setting for initial education and fitting.
Personnel
- Ostomy Nurses or Wound Care Specialists for initial fitting and education.
- Primary care doctors for ongoing management.
Risks and Complications
- Skin irritation or breakdown around the stoma.
- Leakage or detachment of the pouch.
- Rare allergic reactions to adhesive materials.
- Infection if the stoma area is not kept clean.
Benefits
- Effective management of urinary output.
- Improved quality of life with secure fit and leak prevention.
- Comfort and ease of use, allowing for routine lifestyle maintenance.
Recovery
- Patients can return to daily activities almost immediately after deploying the pouch.
- Regular maintenance and care of the stoma and pouch are necessary.
- Follow-up appointments to check on stoma health and fit of the pouch.
Alternatives
- Two-piece ostomy systems that separate the barrier from the pouch.
- Non-convex pouches for stomas that do not require additional support.
Other urinary diversion options, such as indwelling catheters or continent urinary reservoirs.
Pros: Easy application, fewer pieces to manage.
Cons: May not be ideal for all stoma shapes and types.
Patient Experience
- Patients might feel anxious at first but typically find the process manageable with proper guidance.
- Pain or discomfort is generally minimal; however, skin irritation can occur but is manageable with proper care.
- Support from healthcare providers and ostomy support groups can be incredibly beneficial.