What to Expect Before Ostomy Surgery

If you’re scheduled for ostomy surgery, you’re probably feeling anxious or even a little scared. It’s important to know that ostomy surgery is simple and common — around 100,000 Americans get the procedure each year. Ostomy is life-changing, and for many people it’s also life-saving. Here’s what to expect before your surgery.

Pre-Operative Consultation

Before your surgery, you’ll meet with your doctor to discuss your upcoming colostomy, ileostomy or urostomy. The doctor will explain how the surgery works, whether it’s temporary or permanent, the risks and benefits of ostomy, and potential complications. You’ll be asked about your health habits, such as smoking and alcohol use, and about any medications you take. You’ll also learn what you need to do to prepare for surgery, such as refraining from eating and drinking for a certain period of time.

It’s a good idea to write down any questions you have, such as:


  • How long will I be in the hospital?
  • How long does recovery typically take?
  • How do I manage post-surgical pain?
  • When will I be able to eat again?
  • How will my ostomy affect my sexual and reproductive health?


You may also undergo a physical assessment before your ostomy surgery and speak to the anesthesiologist. As your surgery date approaches, make sure you follow all the instructions your surgeon gives you, which will likely include fasting for at least 12 hours before the surgery. You may be given laxatives or other medications.

Wound, Ostomy, and Continence (WOC) Nurse Consultation

Your WOC nurse is there to teach you the practical skills needed for living with an ostomy. They’ll explain how the stoma works; how to apply an ostomy pouching system, how to care for your peristomal skin; the ostomy products you’ll need; and more. If you feel overwhelmed by the amount of information, don’t worry! Your WOC nurse will continue to care for you after your ostomy surgery, and will be on call when you have questions.

Stoma Site Selection

Shortly before your ostomy surgery, your surgeon and/or WOC nurse will determine the optimal location for your stoma. This is an important decision, because correct stoma placement can ensure a good fit with your ostomy pouching system and help reduce problems after surgery, such as leakage, skin irritation and pain.

Stoma placement depends on several factors, including:


  • The type of ostomy you’re having: For example, the stoma is typically placed on the lower left side of the abdomen for a descending colostomy, while it’s placed on the upper abdomen for a transverse colostomy.
  • The shape of your abdomen: If you have a rounder abdomen, the stoma may be sited higher so you can see it better.
  • Your natural waistline: It’s best to avoid placing the stoma where the waistband of your pants or skirt will constrict it.
  • The characteristics of your skin: Ideally, the skin around your stoma will be smooth, to ensure a good seal with your ostomy pouching system. Creases, folds, wrinkles and scars make it more difficult to get a leak-proof seal.
  • The location of your abdominal muscles: Placing the stoma within the rectus abdominis muscle can help prevent certain complications, such as stoma prolapse or peristomal hernia.


Your medical team will examine you sitting, standing, bending and lying down, so they can take into account the way your body folds and moves.

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