Infections after Urostomy
Dear OncoLink "Ask The Experts,"
My husband had his bladder and prostate removed in April 2005. Both the bladder and prostate contained primary cancers. He now has a urostomy and is managing well, but he keeps getting urinary infections. I am concerned about him taking antibiotics and the strain of these infections on his kidneys. Is there any way that we can prevent these infections, please? He is very careful with washing hands, etc when changing his bag. Please help if you can. Many thanks.
Alan J. Wein, MD, Professor and Chair of the Division of Urology at the University of Pennsylvania School of Medicine, responds:
Patients with urostomies, especially conduits, are at increased risk of urinary infections.
If your husband is asymptomatic (meaning he is not bothered by symptoms), and the bacteria won't clear with antibiotics, it may just represent chronic bacteriuria, meaning bacteria is repeatedly found in the urine. Before establishing this diagnosis, which requires no specific treatment other than routine follow-up and observation, one should look for and rule out possible sources of infection, such as kidney stones, exposed surgical sutures or clips in the conduit itself, etc.
If the infections are symptomatic and the urologist is unable to solve this, then you should request a referral to an experienced infectious disease specialist, who is an expert in treating difficult infections.