You are working on a postoperative surgical floor and are assigned to A.T., a 65-year-old woman with a

Question

30-year smoking history who has recently had a radical cystectomy with ileal conduit for invasive bladder
cancer.

You begin your assessment and look at the transparent urostomy pouch covering the ileal
conduit. The stomal opening is red and is draining urine with mucus. Is this normal? Explain
your answer.

Answer 1

Yes, this is normal. A 6- to 8-inch segment of the ileum, with intact mesentery blood supply, is
resected from the bowel, the end is folded over on itself like an ankle sock, and it is sewn to an
opening made in the abdominal wall. The distal end of the ileal conduit is positioned such that
peristalsis will assist transport of urine through the conduit and out of the stoma. The ureters coming
from the kidneys are attached to the piece of ileum, resulting in urine draining through the artificial
abdominal opening. The stoma is usually located in the right lower quadrant of the abdomen. The
segment of bowel still functions as small bowel—that is, it still produces mucus designed to facilitate
the movement of stool through the small bowel. The stoma is red, wet, and slippery if it has good
circulation and mucus drains out with the urine.