The dark side of a urostomy

Mrs Amanda Jones1
1Northern Adelaide Local Health Network , Elizabeth Vale , Australia

Introduction: Post-operative management of an ischemic stoma can vary; in most cases immediate surgical revision is warranted. This poster discusses the management of an ischemic urostomy, in which the ostomy was not immediately revised.  The patient was acutely unwell in the immediate post-operative period; he was also admitted to hospital on two occasions post discharge home.

Background: A 61 year old male pensioner who lives alone with a supportive daughter and young grandchildren. The patient presented with macroscopic haematuria with clots and difficulty voiding. An invasive TCC bladder carcinoma was diagnosed; the patient underwent neoadjuvant chemotherapy.  Following this the patient underwent a radical cystoprostatectomy, extensive pelvic node dissection, appendicectomy, enteroenterostomy + ileal conduit diversion

Method: Numerous post-operative complications were encountered; the patient was acutely unwell in the immediate post-operative period. The STN expressed concerns to the urology team that the ostomy was dark brown in colour. The urostomy continued to be monitored by the surgical team and STN.

Conclusion:  This poster identifies the role of stomal therapy nursing in patient management and supporting the patient through challenging times.  An ischemic stoma can dramatically affect the ostomates quality of life initially through a prolonged hospital admission .Post-operative management can vary; in this case immediate revision was not warranted by the surgeon. It was essential to find an appliance that the patient had confidence in, in order to re-establish a good quality of life.


Biography:

Amanda currently works at the Northern Adelaide Local Health Network as a Stomal Therapy Nurse Consultant. This encompasses two hospitals-Lyell McEwin and Modbury Hospital.

Amanda completed a Bachelor of Nursing at the University of South Australia in 2006 and has worked in a surgical/colorectal setting since graduating.

Amanda completed a certificate in Stomal Therapy Nursing at the Royal Adelaide Hospital in 2013.