Patient Case Study No.5 (UK) – Confidence Natural Urostomy

Patient History

• 80-year-old female
• Bladder cancer 13 years ago. She underwent a radical cystectomy, with formation of a urostomy
• For many years, the patient used a 2-piece urostomy product and had no problems with management
• However, over the last 3 – 4 years, she developed problems with leakages but continued the same stoma care regime
• Until last year, she was leaking daily, day and night
• The patient lost her confidence to go out and started to become depressed
• At this point, she was referred to the Community Stoma Care Nurse Observation on first home visit
• It was noted that the patient had become very concerned regarding the problems with her urostomy, feeling that she was becoming housebound due to the leakages
• She was also very emotional because of the situation, becoming tearful at times
• After a medical history was recorded, we discussed the stoma problems: the patient had used the same 2-piece pouch for the last 13 years and had only recently started to use seals and wafer extenders to solve the problems, but with no success
• She reported a change in the shape of her abdomen, of which she had become self-conscious, and that the peristomal skin felt sore and itchy most of the time
• On examining this patient, it was noted that she had a parastomal hernia. This bulge had changed the position of the stoma, creating an uneven surface and skin creases on the peristomal area (Ref 1 & 2)

TREATMENT

• The patient was very reluctant to try a different pouch, but we both felt that other accessories might not be the solution
• Our aim was to improve pouch adhesion and stop the leakages
• I recommended the new Confidence® Natural 1-piece pouch, as it is designed to mould around contours of the body and has a stronger adhesive to prevent breakdown from the urine

RESULTS

• The pouch stayed intact for 2 days and, for a further 2 weeks, had the same wear time
• The patient was reluctant to use a different pouch but found the Confidence® Natural pouch easy to apply, fitting her body shape and adhering well to the skin (Ref 3 & 4)

OUTCOME

• The patient no longer has any daytime or nighttime leakages and feels more secure with the Confidence® Natural pouch, and it fits around her parastomal hernia shape
• The hydrocolloid wafer infused with Aloe Vera improved the problem of her feeling sore on the peristomal skin and stopped the itchy skin, which was an added result that we were not expecting
• But, most importantly, the Confidence® Natural urostomy pouch gave this patient the confidence to start going out again and enjoying her life without the fear of leakages

CONCLUSION

• Confidence® Natural prevented leakage for this patient
• The pouch provided a longer wear time, thus assisting the peristomal skin healing process
• The Aloe Vera helped soothe the skin and stopped the itchiness previously experienced
• This patient regained confidence to enjoy her life again