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Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each

HCPCS code

Name of the Procedure:

Common Name(s): Ostomy Pouch Technical Term: Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each (A4433)


An ostomy pouch for urine collection attached via a locking flange system is used by individuals with urinary diversions or urostomies. The two-piece system involves a barrier that adheres to the skin and a detachable pouch for urine collection.


This medical device addresses the needs of individuals who cannot urinate normally due to bladder issues, bladder removal, or other urinary tract problems. The goal is to ensure a secure and hygienic method of collecting urine from an ostomy site, allowing individuals to carry on with daily activities comfortably and without leakage.


  • Bladder cancer leading to cystectomy (bladder removal)
  • Congenital anomalies of the urinary tract
  • Severe bladder dysfunction
  • Trauma or injury to the bladder or urinary tract

Patient criteria:

  • Individuals who have undergone urostomy surgery.
  • Those requiring a reliable urine collection and management system.


  • Clean the surrounding skin area thoroughly.
  • No fasting or special medication adjustments are typically required.
  • Patients might undergo routine check-ups to ensure suitability for the pouch.

Procedure Description

  1. Clean the ostomy area: Use gentle cleansers and ensure the skin is dry.
  2. Apply the barrier: Adhere the skin barrier (flange) to the skin around the stoma.
  3. Attach the pouch: Secure the urine collection pouch to the barrier using the locking system.
  4. Tools: Ostomy barrier, locking flange system pouch, cleansing materials.

Anesthesia: Not applicable.


Initial setup may take around 15-30 minutes. Subsequent pouches are quicker to change.


Typically done at home once the patient is trained, initially taught in a clinical setting.


  • Ostomy nurse or specialist for initial training
  • Both patient and caregiver for home application

Risks and Complications

  • Skin irritation or infection
  • Leakage if not properly sealed
  • Pouch ballooning due to trapped air
  • Allergic reaction to adhesives


  • Secure urine collection with minimal leakage
  • Increased mobility and confidence
  • Ability to manage urostomy independently after training Benefits are usually realized immediately after proper application.


  • Patients follow normal daily routines.
  • Regular care involves changing the pouch and cleaning the skin around the stoma.
  • No specific recovery period is associated as it is a maintenance procedure.


  • One-piece ostomy systems: Easier application but less flexibility.
  • Permanent catheters or internal urinary diversions: More invasive with higher complication risks. Both options have distinct pros and cons related to ease of use, comfort, and control over urinary output.

Patient Experience

  • Initial discomfort and adjustment period.
  • Training helps in painless, routine application.
  • Pain management involves using skin-safe adhesives and avoiding irritated areas. Comfort measures include regular cleaning and monitoring skin health.

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