Urostoma’s The postoperative care Ronny Pieters, RN EAUN Board member Chairman Urobel

Pre-operative Preparing the patient Physical Psychological What has the patient understood? Depending on the patient wants to know it all wants to know what’s needed Re-assuring: “we will take care of you”

Post-operative Intensive care or PACU Specialised in intensive care Specialised in urologic nursing

Post-operative 2 Ureterkatheters Drain Naso-gastric tube Central catheter PCA 2 Ureterkatheters Drain Stoma Sub-cutaneous drain

Post-operative IV-therapy Naso-gastric tube Full parenteral nutrition ~5 days PCIA ~3 days (or PCEA) Naso-gastric tube Under aspiration Till bowel movement Gradual feeding

Post-operative Sub-cutaneous drain Drain Ureter catheters Removed when minimal drainage Drain Mobilised after 7 days Ureter catheters In situ for 12 days In beginning monitoring of urineoutput from both catheters seperately

Post-operative Stoma Catheter in stoma Applied with stoma-appliance Catheters in bag or pull-through When dressing on stoma, moisturized cream

Post-operative Patient care Explain the different catheters Explain the PCIA Inform on the aspect of the urine Inform on the coming days Inform on stoma care (Françoise) Start preparing the discharge home

Post-operative In case of pouch, neo-bladder Catheter in the pouch or bladder Flushed (mucus) every 4 h Usually more than one catheter to avoid filling of pouch or neo-bladder