Urostomy Care: What a 2026 Evidence Synthesis Means for Patients

A urostomy is a type of ostomy that reroutes urine, rather than faecal output, through a stoma on the abdominal wall. For people living with a urostomy, the day-to-day care routines are distinct from those of an ileostomy or colostomy, and the evidence base for how those routines should be structured has continued to grow.

A June 2026 study published in BMC Nursing addresses this directly. Using a systematic review of the nursing literature combined with a modified Delphi consensus process involving specialist nurses, the researchers identified and validated the core components of evidence-based nursing care for adult patients with a urostomy (BMC Nursing, 2026). The study's contribution is a structured, expert-agreed framework that connects published evidence to clinical practice in a form nurses can apply and patients can ask about.

What a Urostomy Is

A urostomy is created surgically to allow urine to leave the body through a new opening in the abdomen when the bladder can no longer function or must be removed. The most common type is the ileal conduit, in which a short segment of the small intestine is repurposed to carry urine from the ureters to the stoma. Because the small intestine continuously secretes mucus, the output also contains some mucus alongside the urine, which is normal.

Urostomies are most often created after bladder removal for cancer but also occur following severe spinal cord injury, complex pelvic conditions, or certain conditions affecting the urinary tract from birth. Unlike ileostomies and colostomies, a urostomy drains continuously, so the pouching system must be able to manage a constant liquid output at all times. Urostomy pouches typically include a tap or valve at the bottom for regular emptying and can be connected to a larger drainage bag overnight.

The NHS notes that most people with a urostomy are able to manage their stoma independently within a few weeks of surgery, with appropriate nursing support and education provided both before and after the procedure (NHS: Urostomy).

Why the Evidence Base for Urostomy Care Matters

Stoma care for colostomies and ileostomies has historically received more research attention than urostomy-specific care, partly because faecal ostomies are more common. Yet the care demands of a urostomy have their own clinical specifics, including the challenge of maintaining a reliable seal against continuous liquid output, monitoring for urinary complications such as infection, and supporting a patient group that often includes older adults who have recently undergone major cancer surgery.

In practice, nursing care protocols for urostomy have often relied on extrapolation from broader ostomy care evidence, local convention, or individual nurse experience rather than on structured evidence synthesis or formal consensus. The 2026 BMC Nursing study set out to change this by producing a validated framework drawn from systematic review and structured expert agreement.

The Study Methodology

The researchers used two complementary methods. First, a systematic review of the published nursing literature on urostomy care in adult patients was conducted, pulling together available evidence on care components including stoma assessment, peristomal skin management, pouching system selection, patient and caregiver education, follow-up structure, and complication recognition.

Second, the findings from the literature review were taken into a modified Delphi process. In this widely used consensus methodology, a group of nursing specialists independently rate the importance and appropriateness of specific care practices, see the aggregate distribution of responses between rounds (without seeing individual ratings), and have the opportunity to revise their own ratings. After multiple rounds, items that reach convergence toward high ratings are identified as consensus-supported recommendations, while items that remain contested are flagged as uncertain.

The combination of a systematic evidence review with a modified Delphi process is a recognised approach for producing clinical recommendations in areas where evidence exists but has not yet been translated into consistent, structured practice guidance. The result is a framework that reflects both what the research shows and what experienced nursing specialists agree on in practice.

Core Areas of Urostomy Nursing Care

Studies using this kind of methodology typically converge on several care domains that matter directly to patients. For urostomy specifically, those include:

Stoma assessment. Regular review of stomal appearance, shape, and size supports early identification of changes that may indicate complications. Urostomies can develop stenosis (narrowing of the stomal opening), retraction, or prolapse, any of which affects function and may need clinical attention.

Peristomal skin care. The skin around a urostomy is at risk of irritation from urine contact, particularly if the pouching appliance does not fit well or if the seal breaks down. Peristomal skin problems are one of the most common complications of ostomy care overall, and in urostomy they can be compounded by factors such as urinary crystallisation on the skin, which occurs when alkaline urine deposits crystite on the peristomal area. Keeping the skin in good condition is a primary care goal.

Pouching system selection and fit. No single pouching system works for every urostomy patient. Factors including stoma height, peristomal skin contour, physical dexterity, lifestyle, and body shape all affect which system will maintain the best seal. A well-fitted appliance that drains reliably is foundational to both skin health and daily confidence.

Patient education. Teaching patients and their caregivers how to change the pouching system, how to interpret urine appearance and smell, how to maintain adequate fluid intake to reduce infection risk, and when to contact the stoma care team are all components of structured urostomy education. Evidence consistently links thorough patient education with better outcomes after ostomy surgery.

Complication recognition. Early identification of urinary tract infection, parastomal hernia, stomal complications, or skin breakdown before they worsen is part of ongoing care. Patients who know what to look for, and who to contact when they see it, are better placed to get timely clinical input.

Ongoing follow-up. Regular nursing contact after discharge, whether in person, by telephone, or through remote check-in, supports patients through the period when complications are most likely to emerge and when adaptation to the new routine requires the most active support.

What This Means for Patients

For people living with a urostomy, a study like this is useful in several ways. It confirms that the care components that matter most to daily function and long-term skin health are identifiable, teachable, and agreed on by specialist nurses. It also provides a basis for knowing what to expect from structured stoma care support, and what to ask if that support is not yet in place.

If you have a urostomy, questions worth raising with your stoma care nurse or medical team include how your appliance fit will be reviewed over time, how to recognise early signs of infection or skin irritation, and what the plan is for follow-up now that initial recovery is complete. The NHS confirms that stoma nurses are central to this process and that follow-up support is an expected part of urostomy care, not an optional extra (NHS: Urostomy).

This is particularly relevant for people who had their urostomy as part of bladder cancer treatment, where oncology follow-up may absorb clinical attention and stoma care follow-up sometimes receives less consistent focus.