Ask the Ostomy Nurse

Linda Coulter has been a Certified Wound Ostomy & Continence Nurse for 10 years. In addition to working with hundreds of people with stomas, she has trained several WOC nursing students at the R.B. Turnbull Jr. School of WOC Nursing. Linda has presented nationally and internationally on ostomy related topics. From her home base at University Hospitals’ Ahuja Medical Center, Linda is active in raising Ostomy Awareness, and works to distribute ostomy supplies to people in need throughout the world.

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Strong Odor

I had urostomy surgery in 2003 for bladder cancer. I have noticed quite an odor from my stoma and subsequently changed my urostomy appliance. Is that normal to have a lot of odor from the stoma?

W.B.

Dear K.T.,

Thank you for this important question. Odor in the urine can have a few causes. Some, such as eating asparagus and taking B vitamins, do not indicate there is a problem. But a strong or foul odor can be a symptom of a medical issue including dehydration, urinary tract infection (UTI), uncontrolled diabetes, or another medical issue. Additionally, medications, including antibiotics like Bactrim, can also lead a strong odor from the urine.


Urine from your stoma should be a light yellow color and with little to no odor. Dehydration will concentrate urine, causing it to be a dark yellow or gold color and to have a strong odor. Eating fruit, drinking fluids with electrolytes like coconut water or adding electrolytes to water will help you stay hydrated. Consume more during summer months or when perspiring more.

Drinking plenty of hydrating fluids can also decrease the chance of developing a UTI. While people who have bladders may experience urinary frequency, pelvic pain, and burning during urination if they develop a UTI, people with urinary stomas or urostomies (ileal conduit, ureterostomy, Indiana pouch) will notice different signs and symptoms. These include strong or foul-smelling urine, fever, chills, nausea, vomiting, flank pain (kidney area) and fatigue. The only symptom that older individuals may demonstrate is confusion, whether they have urinary bladders or urinary stomas. Cloudy urine can also be a symptom of UTI, but it is normal for people with urostomies to have some shreds of mucous in their urine. If you suspect that you have a urinary tract infection, it is important to contact your doctor.

It’s also important to contact your doctor if your urine has a sweet or fruity odor, which is a sign of undiagnosed or uncontrolled diabetes. Liver disease and kidney stones can also cause urine to have an unusual odor and require a physician’s attention.
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