Having a urostomy can take some adjusting to and knowing how to handle issues before they arise can really help you feel equipped and ready to deal with those blips when they occur. Many ostomates will worry about night times and have many questions such as whether they need to get up during the night to empty their pouch? Should they set an alarm for 2am? Is there a particular sleep position which is best? What if I knock my stoma? Hopefully we will answer these questions for you and guide you as to the best tips to aid you to having a good night’s sleep. It’s important to note there is no set rule and we are all different, it is about learning what works for you.
Unfortunately, most ostomates will tell you they have experienced a leak at some point, although this is not something that should happen frequently or something you should put up with. Often most of these leaks can happen whilst you are asleep during the night! Not only does this cause the obvious embarrassment when you share a bed, but also the frustration as not only is your sleep disturbed and you may find yourself getting up to empty your pouch, changing bed clothes and stripping sheets, which is predicament no one wants to be in, in the early hours of the morning!
Application of pouch:
Spend a little bit of time before you go to bed making sure your pouch has adhered to your skin well. Make sure the edges of the flange are smooth, without crinkles and are stuck well. Smooth the edges with your fingers to check all around the edges. Occasionally if you are tired and the pouch isn’t quite stuck then the edges can easily lift and then before you know it, you have a leak!
Emptying your pouch before bedtime:
Always make sure you empty your pouch just before you get into bed. There are not many people with a urostomy who can make it through the night without having to empty their pouch. If you are a night owl and an early riser you may just manage without having to emptying the pouch but for the rest of us, a urostomy bag will need emptying at least once throughout the night. If you are happy getting up to empty the contents of your pouch during the night then this is fine, for others they may not want their sleep disturbing and therefore using a night drainage bag is the answer.
What are night bags?
The night drainage system is a large 2 litre bag which can simply be attached by a long piece of tubing to the end of your urostomy pouch. It can hang from a nightstand at the end or by the side of your bed, so it is not obvious. In the morning you easily disconnect the night or leg bag and drain the contents down the toilet. Some night bags simply attach to the drainage end of your urostomy pouch, others may need a connector/adaptor, so just check you have all the correct equipment from your supplier or stoma care nurse. Some people prefer to wear a leg bag overnight as an alternative.
Some of these night bags are disposable, so they are disconnected, and the urine is drained each morning and the bag is disposed of after each use. Others are re-usable and will need emptying at the bottom, washed out with warm soapy water, and hung over the shower to dry. If you are using a re-usable night bag, make sure you dispose of it and start with a new one every 5-7days to prevent any bacterial build up in the tubing which may cause urinary tract infections (UTI’s).
Sleeping positions:
This can be a worry for some. Many of us sleep on our tummy and this can put pressure on your stoma and interfere with your stoma pouch, especially when it is filling up. If you need to sleep on your tummy, then enjoy a quick 10mins and try to change positions by then rolling onto your side or back. Often sleeping with a pillow behind your back or between your knees can prevent you from rolling forwards or backward again. It also helps so your feet don’t get tangled with your night bag tubing.
Try this tip: Your position in bed might be a little restricted if you are wearing a night bag, as the long tubing can easily get taggled with your lower legs and feet. Try threading the tubing through your pyjama bottoms, before connecting to the urostomy pouch, as this can help.
Flat and retracted stomas:
Some stomas can be flat or flush to the skin of your tummy. Ideally, they should have a spout which helps all the contents go into your pouch, but many don’t. There is nothing wrong if you have a flat/flush stoma, but you may find you are more likely to leak and often at night, which can result in sore skin. If you notice your stoma is flat/flush and you are experiencing leaks night or day, then speak to your stoma care nurse and she will help you select a more appropriate pouch and monitor your progress.
Pancaking:
Pancaking is a term which is used to describe the stoma output sticking to the plastic inner lining of your stoma pouch, causing the contents to not drop into the bottom of the pouch. It then pools around the stoma area and pushes the pouch away from the body. This can result in leaks and sore peristomal skin, happening anytime of the day or night!
Try these tips:
- Put some air into the pouch by blowing into the pouch prior to application, then apply a filter cover, this will make sure some of the air remains inside the pouch to prevent any vacuum. Once you have had a bowel movement, remove the filter cover. This will hopefully allow the stool to drop to the bottom of the bag.
- Some people find it helpful to use a drop of oil into the pouch through the hole/aperture of the adhesive before applying, make sure you lubricate the opposite side of the internal film so when the stoma touches the material it will not stick, and the stool can slide to the bottom of the pouch.
- Rolling a small piece of toilet paper or cotton wool ball and dropping into the bottom of the pouch before you apply your pouch, can help provide some weight to the bag and the vacuum will hopefully then not occur.
