Guest: Dr. Lynette E. Franklin - APRN-BC
Host: Dr. Linda Austin – Psychiatrist
Announcer: Welcome to an MUSC Health Podcast.
Dr. Linda Austin: I am Dr. Linda Austin. I am interviewing Lynette E. Franklin, who is an Advance Practice Nurse, and we are going to be talking about urostomies, which is a procedure that occurs in our Urology Clinic here at the medical university. Lynette, can you describe, if you would please, what is a urostomy?
Lynette E. Franklin: Urostomy is any opening that’s not the natural opening for urine to be taken out of the body. Ostomy means opening and UR is for urine. There is all different types of ostomies, some for stool and then also for urine. Anybody from the age of birth until adulthood could potentially have urostomy. The reasons that somebody may have a urostomy are due to trauma, cancer, birth defects, or anything that would cause the urine not to come out correctly or nonfunctioning bladder. Different types of urostomies can be either a restructuring of the whole urinary tract system meaning that the bladder can be removed and a new piece of bowel can be put in to help direct the urine. This is called an ileal conduit. An ileal conduit is one of the small piece of intestine is taken from the GI tract and hooked up to the ureters, and then the end is brought to the skin surface and now when the kidneys make the urine, it drains down into the ureter and out the conduit. Conduit just means holder, so what happens is there is a little stoma or opening on the skin surface. It’s bright red and looks likes a little rosebud and this is where the urine will exit. We pouch this area with a pouch to contain the urine and that’s emptied every four to six hours depending on how much you drink. The pouch is changed every three to five days typically and part of a Wound, Ostomy and Continence Nurse job is to help you -- the patient learn how to look after urostomy.
Dr. Linda Austin: So, then do some patients have ostomies for the rest of their lives?
Lynette E. Franklin: For bladder cancer where your bladder is removed, yes, a urostomy is for the rest of their lives.
Dr. Linda Austin: What are the restrictions in daily life that patients may have when they have a urostomy?
Lynette E. Franklin: It can be very overwhelming to find out that you are going to have to have a urostomy. In terms of eating, nothing changes; you may be more aware of what you eat in the smell of your urine; for example, if you eat asparagus, some people find that they have asparagus-smelling pee and that’s not going to change after urostomy. You can swim, you can still have sexual relations, you can do all sports except contact sports meaning football, rugby, or wrestling are the sports that you just need to avoid, but other than that, everything that you did prior to having an ostomy, you will be able to do after. Actually, one in every 200 people that you would see walking in the mall has some type of ostomy appliance. And many times, a lot of people have one and we just don’t even realize it because it’s not one of those things that you ask around the Thanksgiving table, how do you pee Uncle Fred, you just don’t ask that. So, I am sure people have friends or acquaintance, who have an ostomy, but they just don’t even realize it because quite frankly, they are the same as one of my patients said it’s not the end of life, it’s just peeing from a different end.
Dr. Linda Austin: So it’s sound then as if even though I am sure it’s an adjustment to get used to it that once you are used to it, life goes on pretty much the way it always has.
Lynette E. Franklin: Right and one of the most important things to realize is that you are not alone. The Wound Ostomy and Continence Nursing Society is a group of professional nurses, who have taken extra training to be able to assist before surgery, during surgery, and after surgery helping the patient and the family members adjust to the new changes, not only as your body physically changed, but how you see yourself has changed, and how you learn to look after yourself takes a little bit of time and as professionals were there to help you. There is also a wonderful website that our society maintains at "http://www.wocn.org", which has wonderful resources about different types of pouches that you can use, different support groups that are available and different products that are on the line that may help you adjust to your changes a little bit more easily. 05:02 here in Charleston at MUSC, we have three Wound Ostomy and Continence Nurses and at the hospitals around the area, there are many Wound, Ostomy, and Continence Nurses.
Dr. Linda Austin: Lynette Franklin, thank you so much and we all appreciate the good work you do.
Lynette E. Franklin: Thank you.
Announcer: If you have any questions about the services or programs offered at the Medical University of South Carolina or if you would like to schedule an appointment with one of our physicians, please call MUSC Health Connection at (843) 792-1414.