title: Complexities of management of a urostomy in Ehlers-Danlos syndrome: a reflective account.
abstract: Mary (pseudonym) is a 30-year-old woman who underwent a urinary diversion and formation of an ileal conduit/urostomy (urinary stoma) due to the formation of multiple bladder diverticula, which caused micturition difficulties and recurrent urinary tract infections with associated pain and discomfort. The bladder diverticula were caused by Ehlers-Danlos syndrome (EDS), a hereditary disorder of the connective tissue or, particulary, defective collagen. Surgical intervention in patients with EDS is prone to complications due to poor wound healing, including issues of dehiscence, postoperative bleeding and poor uptake of anaesthesia and analgesia. After an initial presentation of the syndrome of EDS and Mary's history, this article offers a reflective account (informed by Gibbs' Reflective Cycle) and illustrates the complexities of caring for an individual with EDS who undergoes stoma formation. The author, a stoma care nurse, demonstrates how using purposeful reflection resulted in better understanding and awareness of caring for an individual with a rare syndrome and the nursing challenges this presented.
authors.affiliation: Clinical Nurse Specialist, Stoma Care, Hollister Ltd.
authors.forename: Julie
authors.initials: J
authors.lastname: Oxenham
mesh_terms: D004240:Diverticulum / Q000150:complications; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D010348:Patient Care Team; D011183:Postoperative Complications; D012008:Recurrence; D014519:Ureterostomy; D001743:Urinary Bladder / Q000002:abnormalities; D014552:Urinary Tract Infections / Q000209:etiology; D014945:Wound Healing
keywords: Ehlers-Danlos syndrome; Reflective practice; Surgical and stoma complications; Urostomy