Surgery performed on gastro-intestinal and urinary tracts creates its own problems of getting rid of the faces or the urine which now cannot be evacuated through normal openings. New openings may be/can be made by the following operations. These new openings made need constant and effective care.
Colostomy: When the opening is formed from the colon, the stoma is called a colostomy. Stoma may be made from any part of the colon, depending upon where the disease is. When the opening is formed from the ileum part of the small bowel the stoma is known as an ileostomy. This ostomy is made using the ileum, the part of the small intestine that is farthest from the stomach and nearest to the colon. This is done where the colon and the rectum is removed.
As there is no longer a colon to absorb water and form solid stools, the ileostomy discharges liquid which flows almost continuously. This contains digestive enzymes, so the ileostomy stoma is made to protrude up to an inch into the appliance so that the skin is protected. This is important because the enzymes may digest the skin.
Urostomy: In the cancer of the bladder, it may be necessary to totally remove the bladder. This surgical removal of bladder is called urostomy. The ureters, the tubes that connect the kidneys and bladder, may be brought directly up to the skin, or may be connected to the ileum (part of the small bowel) which is brought up to the skin as a stoma. This is called an ileal conduit.
The operation of making ileal conduit, is so called because the surgeon converts a segment of the ileum (about 15 cm) into a pipe, or conduit for urinary drainage. The urethras are disconnected from the bladder (which is usually removed) and are joined to one end of the ileum, the other end of the ileum being brought through the abdominal wall to form the stoma. The segment of the ileum removed from the small intestine survives on its own blood supply and the rest of the bowel is rejoined and continues to work normally.
There is no voluntary control of the stoma which discharges a drop of urine every 10 to 20 seconds. A urostomy bag is worn over the stoma.