Name of the Procedure:

• Common Name(s): Urinary Ostomy Pouch
• Technical/Medical Term: Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each (HCPCS Code: A4432)

Summary

An ostomy pouch for urinary applications is a medical device used to collect urine for patients who have undergone urostomy surgery. This particular type features a faucet-type tap with a valve and fits onto a barrier with a non-locking flange.

Purpose

• Medical Conditions: Used for patients with a urostomy, typically due to bladder cancer, birth defects, severe incontinence, or other conditions requiring the diversion of urine.
• Goals/Expected Outcomes: To provide a reliable and hygienic method of urine collection, ensuring patient comfort and reducing the risk of skin irritation and infection.

Indications

• Symptoms/Conditions: Indicated for patients with a urostomy who need a secure collection system.
• Patient Criteria: Suitable for patients requiring a two-piece ostomy system with a non-locking flange for ease of use and those needing a faucet-type tap for controlled drainage.

Preparation

• No specific fasting or medication adjustments are required.
• Patients may undergo a fitting session with an ostomy care nurse to ensure proper application and usage.

Procedure Description

1. Stoma and Skin Preparation: Clean the stoma and surrounding skin with mild soap and water, then pat dry.
2. Barrier Application: Apply the adhesive barrier to the skin around the stoma.
3. Pouch Attachment: Attach the ostomy pouch to the barrier by aligning the non-locking flange.
4. Securing the Pouch: Ensure the pouch is securely attached and positioned for maximum comfort.
5. Using the Tap: When ready to empty, open the faucet-type tap with valve to drain urine into a suitable receptacle.
   • Tools/Equipment: Ostomy pouch, adhesive barrier, faucet-type tap with valve.
   • Anesthesia or Sedation: Not applicable.

Duration

The fitting and attachment process typically takes 15-30 minutes.

Setting

• Usually performed in an outpatient setting or at home under the guidance of an ostomy care nurse.

Personnel

• Healthcare Professionals Involved: Ostomy care nurse, patient.

Risks and Complications

• Common Risks: Skin irritation, leakage, difficulty in attaching the pouch.
• Rare Risks: Infection, severe allergic reactions to adhesive materials.
• Management: Regular monitoring and proper hygiene, use of barrier creams or protective seals if needed.

Benefits

• Expected Benefits: Improved quality of life due to reliable urine collection, reduced skin irritation.
• Timeframe for Benefits: Immediate upon proper fitting and continuous with regular use.

Recovery

• Post-Procedure Care: Maintaining the cleanliness of the stoma and changing the pouch as recommended.
• Recovery Time: No significant recovery period; adjustments may be necessary during the initial stages.
• Restrictions/Follow-up: Follow up with healthcare provider as advised, typically every few months for stoma evaluation.

Alternatives

• Other Treatment Options: One-piece ostomy systems, different types of urinary diversion techniques.
• Pros and Cons:
  • One-piece System: Easier application but less flexibility in management.
  • Alternative Diversions: May not be suitable for all patients and require additional surgical procedures.

Patient Experience

• During the Procedure: Patients may feel a bit of discomfort during the fitting process.
• Post-Procedure: Initially, there may be a period of adjustment; the comfort level improves over time as they become accustomed.
• Pain Management and Comfort Measures: Over-the-counter pain relief for minor discomfort, regular follow-ups to address any comfort issues.