Dear Nurse: Living Well with a Urostomy: Understanding Infections, Skin Care and Finding the Right Fit

13 August, 2026

By Sue Pridham, Head of Clinical and Nursing Services, Convatec

To mark Urology Awareness Month in September, Sue Pridham talks through how to avoid complications with a urostomy.

Living with a urostomy can take time to adjust to, and it’s completely normal to encounter challenges along the way. While many people go on to live full and active lives, there are some common concerns that can affect day-to-day comfort and confidence. Two of the most frequent issues are urinary tract infections (UTIs) and problems with peristomal skin (the skin around the stoma).

Understanding what to look out for, knowing when to seek help, and finding the right products for you can make a real difference in how you feel and manage your stoma.

Spotting a Urinary Tract Infection (UTI)

Urinary tract infections can be more common for people living with a urostomy, but they are not always easy to recognise. This is because the usual symptoms people might expect—such as needing to pass urine frequently or a burning sensation—often don’t occur in the same way.

With a urostomy, urine drains continuously into your pouch, so there’s no sensation of needing to pass urine. Because of this, some of the typical warning signs are no longer present. In addition, mucus is mixed in with the urine, which can sometimes make it harder to spot changes that might indicate infection. This means that UTIs can occasionally develop without being noticed straight away.

Therefore it is important to become familiar with what is normal for you and watch for changes such as:

• Urine that appears cloudy or darker than usual
• A strong or unusual smell from your urine
• An increase in mucus in your pouch
• Feeling generally unwell, tired, or lacking energy
• Loss of appetite or feeling slightly “off”
• Fever, chills, or back pain, which may suggest a more serious infection

Even small changes can be important. Often, people say they just “don’t feel quite right”—and this instinct should never be ignored.

If you notice any of these changes:

• Contact your GP or stoma care nurse straight away.
• Try to increase your fluid intake, unless you have been advised otherwise.
• A urine sample may be needed – your stoma nurse specialist will be able to advise on the best way to do this.
• Seek urgent medical advice if you develop a temperature, pain, or feel significantly unwell.

Early treatment can prevent the infection from becoming more serious, so it’s always better to seek advice sooner rather than later.

Peristomal Skin Health

Healthy skin around your stoma is key to feeling comfortable and confident. Ideally, the skin should look similar to the rest of your abdomen—smooth, intact, and not red, broken or irritated.

However, when you have a urostomy, the skin can be exposed to urine, which can cause moisture, associated with skin damage and irritation. This can result in erythema (redness) and pain and will require an intervention to resolve. Stoma powder can help with this and it is key to ensure your pouch fits correctly.

Repeated exposure to leakage can lead to hyperkeratosis. While the name sounds complicated, it simply refers to a build-up of thickened skin.

Hyperkeratosis can appear as:

• Thickened or slightly raised patches of skin
• A rough or uneven texture
• White, grey, or yellowish areas
• Dry or scaly skin

It usually develops gradually and may not be painful at first, which is why it can sometimes go unnoticed.

The most common cause is repeated exposure to urine that is more alkaline, often due to small leaks that may not always be obvious.

Although it may not seem serious at first, having sore skin around your stoma can make it more difficult for your pouch to stick properly. This can lead to further leaks, creating a cycle where:

Leakage → Skin damage → Poor seal → More leakage

Breaking this cycle early is important to protect your skin and improve your overall comfort.

There are some simple but effective steps you can take:

• Check your skin regularly when changing your pouch.
• Make sure the opening of your pouch fits closely around your stoma.
• Avoid leaving damaged skin untreated.
• Follow a gentle skin care routine recommended by your stoma nurse.
• Seek advice if you notice any changes that don’t improve.

Remember, healthy skin helps your pouch stay secure, which in turn helps prevent leaks.

Finding the Right Fit

One of the most important parts of urostomy care is using a pouch system that fits well and feels comfortable. Not all stomas are the same, and your needs may change over time.

If you’re experiencing leaks or skin problems, it may be a sign that your current product isn’t the best option for you.

You may hear about convex products during your care. Convex pouches have a gentle outward curve that helps the area around the stoma push slightly inwards. This can help the stoma protrude more and allows the pouch to form a better seal. The urine can then drain more easily into the pouch preventing leakage onto the skin.

Convex products can be particularly helpful if:

• Your stoma sits flat against the skin.
• Your stoma is slightly retracted (dips inwards).
• You experience frequent or ongoing leaks.
• Your body shape makes it difficult to get a secure seal.

For many people, switching to the right convex product can significantly reduce leakage and improve confidence.

There isn’t a “one size fits all” approach. The best product for you will depend on:

• The shape and position of your stoma
• The condition of your skin
• Your body shape and movement
• Your lifestyle and activity level

Working closely with your stoma specialist nurse is the best way to ensure your products are the most appropriate for your needs.

You’re Not Alone

Small changes – like recognising early signs of a UTI, improving your pouch fit, or adjusting your skincare routine – can make a big difference to your comfort and confidence.

If you’re having problems there is help and support available. Your stoma specialist nurse is an expert and often the best place to start. There are also patient support charities which have a wealth of knowledge and expertise.

Talking about concerns, even small ones, can help prevent bigger problems later. Urostomy care can feel overwhelming at times, understanding your body and knowing what to look out for can help you feel more in control.

Key Takeaways

• Changes in your urine or how you feel are important – trust your instincts.
• Healthy skin is key to preventing leaks and maintaining comfort.
• The right product choice, including convexity if needed, can make a real difference.
• You don’t have to manage this alone – support is always there.

Support From Colostomy UK

We offer a wide range of support for people living with a colostomy, including our free Stoma Helpline, live chat support, and opportunities to connect with others through local and online groups. We also provide trusted information and resources to offer practical advice, reassurance, and the confidence to live well with a stoma: colostomyuk.org/support