What's Old is New: WOC Nurse Management of the Wet Colostomy in Gynecological Cancer Patients Across the Continuum of Care

Purpose: To establish the role of the WOC nurse in the management of patients with wet colostomies in gynecological cancer patients, identifying the needs of patients and health care personnel, and identify complications specific to living with a wet colostomy.  

Wet colostomies have gained resurgence for the surgical treatment of locally advanced gynecological cancers thrusting the WOC nurse into unfamiliar territory. Historically a wet colostomy was performed by implanting ureters into the distal sigmoid colon, but data showed that patients experienced metabolic abnormalities, increased risk of UTI’s and kidney damage, along with an increased risk of postoperative complications. The surgical procedure has been modified to implant the ureters into the distal limb of the sigmoid loop colostomy, which functions as a conduit for urine while the proximal lumen allows for flow of feces. The patient has one stoma versus the traditional two stoma approach.

Objective:

Sparse information available in the literature about “standard of care practices” for WOC nurses’ management of wet colostomies.

No established teaching tools available specific to wet colostomies for patients, health care personnel (hospital and homecare based).

No data available for incidence of recidivism secondary to long term complications of wet colostomy surgery (eg. Kidney damage, UTI’s, Metabolic abnormalities).

Outcomes:

Educated GYN surgeons and medical staff regarding standard of care for consulting the CWOC nurse preoperatively and postoperatively for wet colostomy patients.

Developed patient educational material for management of a wet colostomy.

Initiated appropriate referrals to social work, psychiatry, visiting nurse, and sexual rehabilitation.

WOC nursing needs to research topic.