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Changing a urostomy bag, step by step | CION Cancer Clinics
You change a urostomy bag by emptying it, peeling the old one off from the top down, cleaning and drying the skin with plain water while gauze catches the urine, checking the opening is the right size, and pressing the new bag on from the bottom up. It takes ten to fifteen minutes once practised. This page gives the steps in order, the kinds of bag, and the habits that cause leaks. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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The short answer
How do you change a urostomy bag?
You change a urostomy bag by peeling the old one off from the top down, cleaning and drying the skin around the stoma with plain water, checking the opening of the new bag is the right size, and pressing it onto dry skin from the bottom up. The whole thing takes ten to fifteen minutes once you are practised, and most people do it every few days.
When to change it
On a routine day, change it before breakfast, when urine flow is slowest and the skin is easiest to dry. Change it early, whatever the day, if the edge of the seal feels damp, if the skin under it itches or burns, or if the bag has leaked. A bag that is leaking is never worth keeping until the planned day.
Why urine makes this harder than a bowel stoma
Urine flows all the time. There is no quiet moment, so the skin gets wet while you work, and a wet seal does not stick. Everything about the technique below is built around keeping the skin dry for the few seconds it takes to press the new bag on.
Your stoma nurse will have shown you this on the ward. This page is a reminder for home, not a replacement for being taught.Before you start
What to lay out within reach
- A new bag, with the opening already cut or checked against your stoma size
- Warm water and soft, dry cloths or gauze, not cotton wool
- A small towel or rolled gauze to hold against the stoma while you work
- A plastic bag for the old pouch, and a bin
- Scissors and the measuring guide, if you cut your own opening
- Adhesive remover, barrier spray or stoma powder, only if your nurse has advised them
Not sure whether this applies to you?
Ask an oncologistIn order
The change, step by step
Sit or stand in front of a mirror with good light. Wash your hands first.
-
Empty the old bag
Open the tap over the toilet and empty it, so nothing spills when you peel it off.
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Peel it off from the top down
Hold the skin down with one hand and peel the adhesive slowly with the other, top to bottom, so urine runs into the old bag. Never tear it off.
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Hold a cloth against the stoma
A rolled piece of gauze held gently against the stoma catches the urine while you clean. Swap it for a dry one as needed.
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Clean and dry the skin
Plain warm water on soft cloth, wiped outwards from the stoma. No soap with oils or moisturiser, no antiseptic and no spirit unless told to. Pat dry until the skin is completely dry to the touch.
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Check the size of the opening
The hole should sit just clear of the stoma edge, so almost no skin shows. Too big, and urine sits on skin. Too small, and the edge rubs the stoma.
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Apply from the bottom up
Remove the backing paper, lift the cloth away, and place the opening around the stoma, bottom edge first. Smooth the adhesive outwards, then hold a warm palm over it for a minute.
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Close the tap and check
Shut the tap. Run a finger round the edge for lifted corners. Bag the old pouch, bin it, and wash your hands.
Kinds of bag
The choices your nurse will talk you through
One-piece
Bag and adhesive base are a single unit. Simpler, thinner and cheaper per bag, but the whole thing comes off at every change. Good for people who change often or want the flattest profile.
Two-piece
A base plate stays on the skin for several days and the bag clips or sticks onto it. You can swap bags without disturbing the skin. Slightly bulkier, and the join must be checked each time.
Cut-to-fit or pre-cut
In the first months the stoma shrinks, so you cut your own opening with the measuring guide. Once it settles, pre-cut bags save time and give a more exact fit.
Measure again if
- Weight changes noticeably
- The skin near the edge starts to redden
Convex bases and belts
If the stoma sits flat or in a dip, a base that curves inward presses the skin down and helps the stoma stand proud. A belt holds it in place. Both are for the nurse to fit, not to buy on a guess.
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Commonly believed
Four habits that cause leaks, and what to do instead
"Antiseptic or Dettol keeps the stoma clean."
Antiseptics, spirit and scented soaps strip the skin and leave a film that stops the adhesive sticking. The stoma does not need to be sterile. Plain water and a completely dry skin do the job, and the seal lasts longer.
"A bigger hole is safer, so the edge cannot rub."
A gap between the stoma and the opening leaves a ring of skin under constant urine. That is how most sore skin starts. The opening should sit just clear of the stoma edge, and it should be re-measured whenever the stoma changes.
"Leaving it on longer saves money."
The adhesive softens as urine wets it, and a base left too long fails without warning, often at night or out of the house. Leaks cost more, in bags and in sore skin, than a change on the planned day. Ask your nurse how long your kind of bag should stay on.
"Cream or oil on the skin will stop it getting sore."
Greasy creams and oils stop the bag sticking, and the leak they cause makes the skin far worse. If the skin needs protecting, stoma powder or a barrier film that dries clear is what a nurse will suggest.
!
What to look at every time the bag is off
A healthy stoma is pink or red, moist and slightly raised. If it has turned dark purple, grey or black, if it has pulled back below the skin, if it is bleeding and will not stop with gentle pressure, or if no urine has come out for several hours, contact your surgical team or go to the hospital the same day. Do not wait to see if it improves by the next change.
Being straight with you
What this page cannot tell you
It cannot tell you which bag suits your stoma, because that depends on its shape, where it sits on your belly, and the folds of skin around it when you sit and bend. A stoma nurse works that out by looking, and it often takes a few changes to get right.
Who this routine is not written for
This page describes an ileal conduit, a urostomy that drains into a bag all the time. If you have a neobladder or a continent pouch emptied with a catheter, there is no bag and none of this applies. It also does not cover a bowel stoma, which uses a different bag and a different routine.
When to stop managing and ask for help
If the bag lasts less than a couple of days before leaking, if the skin under the base is red, broken or weeping, or if you dread every change, the problem is the fit rather than your technique. That is a one-visit fix for a stoma nurse and not something to struggle with for months.
If your centre has no stoma nurse, call the CION helpline. We will help you find one in Hyderabad or your district.Questions we are asked
Common questions about changing a urostomy bag
How often should the bag be changed?
Most one-piece and two-piece bases are changed every few days, with the exact interval depending on the make, your skin and the weather. Change earlier, always, if the edge feels damp or the skin under it itches.
Urine keeps flowing while I clean. How do I dry the skin?
Hold a rolled piece of dry gauze against the stoma with one hand while you clean and dry with the other, swapping it as it wets. Changing first thing in the morning, before drinking, is when flow is slowest.
The stoma bleeds a little when I wipe it. Is that normal?
A few spots of blood from the surface of the stoma when it is wiped are common, because it is lined with the same tissue as the inside of the mouth. Bleeding that keeps going, or blood coming from inside the stoma in the urine, is different and needs a same-day call to your team.
My stoma is getting smaller. Is something wrong?
No. A stoma shrinks over the first months as the swelling from surgery settles, which is why cut-to-fit bags are used at first. Measure it at every change with the guide and cut the opening to match. Once the size stops changing, you can move to pre-cut bags.
Can I reuse a bag to save money?
A one-piece bag should not be reused once the adhesive has come off. With a two-piece system, the bag can be rinsed and re-clipped a few times while the base stays on, if your nurse agrees. Reusing a base that has lifted is what causes leaks and sore skin.
It is hot and sweaty here. The base keeps lifting. What helps?
Dry the skin thoroughly, and hold a warm palm over the base for a full minute after applying it. A barrier film and a belt both help in heat, and some makes hold better in humidity than others. Carry a spare in the hot months.
Can I shower with the bag off?
Yes. Water does not go into the stoma and does not harm it. Many people shower on a change day with the bag off, then dry the skin and put on a fresh bag. Avoid oily soaps and moisturisers on the skin around the stoma, because they stop the adhesive sticking.
My mother cannot see well enough to do it. Who can help?
A family member can be taught on the ward, just as she would be. Ask the stoma nurse to train two people, so no one is stuck if the usual helper is away. Pre-cut bags, a magnifying mirror and good light make it easier for her to do at least part of it herself.
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Sources
- American Cancer Society — Urostomy guide
- Macmillan Cancer Support — Urostomy
- Cancer Research UK — Treatment for bladder cancer
- NHS — Bladder cancer: treatment
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Skin Problems Around a UrostomyWhat sore skin under the base means and how to settle itUrostomy Supplies in Hyderabad and What They CostWhere to buy bags and what a month's supply involvesLife With a Urostomy BagHow the routine fits into an ordinary daySmell, Leakage and Confidence With a UrostomyWhen a leak happens away from homeStoma Nurses and Support in HyderabadWho can fix a fit problem in one visit
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Bag leaking or skin getting sore?
Tell us what is happening and where you are. We will help you reach a stoma nurse and a surgical oncologist who can check the fit. One helpline serves every CION centre.