Urostomy Complications: A Narrative Review for Emergency Clinicians.

BACKGROUND

A urostomy is a diverting measurement for urine outflow. These are necessary for several conditions, but several complications may occur following urostomy creation.

OBJECTIVE

This narrative review provides emergency clinicians with a focused overview of urostomy complications.

DISCUSSION: A urostomy is used in the management of several conditions, most commonly bladder cancer, but also trauma, congenital disorders, and neurogenic bladder. The most common type of diversion is a non-continent cutaneous diversion using the ileum as a conduit. There are a number of complications that may occur, divided by time from surgery. Early complications occur within the first 90 days from surgery. These may include gastrointestinal complications (paralytic ileus, bowel obstruction, anastomotic leak), infection (urinary tract obstruction, intra-abdominal), genitourinary complications (ureteral obstruction, urinary leak), skin and wound complications (infection, superficial skin separation, subcutaneous seromas, dehiscence), and venous thromboembolic disease. Late complications occur past 90 days from surgery and include mechanical and stomal complications (retraction, stenosis, obstruction, herniation, prolapse), skin (skin damage, pseudoverrucous lesions), metabolic disorders, and ureterolithiasis. Rare complications include encephalopathy, continent pouch rupture, and fistula. Many of these complications require surgical specialist and stoma care consultation.

CONCLUSIONS

An understanding of urostomy complications can assist emergency clinicians.