Overcoming problems with stoma site placement and improving quality of life after urinary diversion

Mrs Patricia Walls RN. STN.1
1St Vincent’s Northside Brisbane, Queensland, Australia, ,

Stoma placement requires careful assessment preoperatively. However, post-operatively, changes in body contours can occur that cause problems with stoma  management. Complications after any major surgery can be distressing for a patient and inhibit recovery and rehabilitation particularly if leakage occurs. In 2014 in Australia, there were 2,748 new cases of bladder cancer diagnosed1. In 2015, radial cystectomy was associated with high morbidity (50%) and mortality (8%). In Australia, length of hospital stays (LOS) for radical cystectomy ranges between 10 to 20 days with an average LOS of 14 days. Prolonged length of stay (>14 days) is not uncommon2. Approximately 75 to 80% of patients experience one or more complications despite improvements in surgical techniques, ostomy appliances and ostomy care3,4. The predominant complications are peri-stomal skin related. The challenge for the stomal therapy nurse is to provide a patient-centered care approach as well as the implementation of practical stomal therapy ‘tricks of the trade’ when ostomy problems arise to ensure the best possible outcomes for patients. The case study will outline the care of an elderly patient who underwent a radical cystectomy and creation of an ileal conduit. ‘Tricks of the trade’ used to overcome problems associated with constant leakage and his subsequent loss of self-esteem will be discussed.


Patricia Walls is a Clinical Nurse Consultant, Stomaltherapy and Wound Management,  St Vincent’s Northside , Brisbane .

Pat completed the Stomal therapy course at the Princess Alexandra Hospital in Brisbane in 1982 and a Graduate Certificate in Wound Management at the University of Central Queensland in 1999. Her Stomaltherapy experience has covered community, paediatric and in the acute care setting.

Pat is actively involved with Stomal therapy nursing, participating at National and International  conferences.