Photographic assessment of urostomy characteristics after ileal conduit diversion: a feasibility study

A well-functioning urostomy is essential for quality of life after radical cystectomy with ileal conduit diversion. However, objective external characteristics of a well-functioning urostomy remain poorly defined. This feasibility study investigated whether postoperative photographs can be standardized and used to assess relevant urostomy characteristics.

This single-centre study included 49 patients who underwent radical cystectomy with ileal conduit between June 2022 and December 2022. Immediate postoperative photographs were analysed. Urostomy characteristics, i.e. location, morphology, colour and height were evaluated by two experts using predefined criteria. Photographic standardization was reviewed by a medical photographer.

Of 49 patients, a total of 89 photographs were available; 49 overview (55%), 31 close-up (35%), and 42 side-view (47%). Urostomy location, colour, and morphology were assessable in 82-88% of cases. Mesentery location was assessable in only 48% and lacked reproducibility. Height and size could not be measured due to absence of a scale. Inter-observer agreement between the two experts and the wound, ostomy and continence nurse (WOC nurse) was 100% on whether a characteristic could be assessed in a photograph, with no discrepancies in scoring. The medical photographer identified substantial variability in lighting, angle, and composition and provided recommendations for standardization.

Photographic documentation of urostomies is feasible and allows for reliable assessment of several characteristics. Standardization is essential for reproducibility. Future studies should correlate standardized photographic characteristics with functional outcomes to define determinants of a well-functioning urostomy.