Purpose: To clarify the actual conditions for acquiring stoma care skills related to defecation and urination and to evaluate the factors influencing skill acquisition and independence among ostomates after stoma construction.
　Methods: The present, single-center cohort study enrolled 107 patients who underwent stoma construction between January 1 and December 31, 2013. Changes in their skills and independence status related to defecation and urination during inpatient and post-discharge stoma outpatient care were followed to April 30, 2019. The time required to learn how to change, empty, and order an ostomy pouch was evaluated. The Kaplan-Meier method and Cox proportional hazard model were used to examine the effects of sex, age at surgery, disease, urgency of surgery, type of stoma, and preoperative activities of daily living（ADL）on independence status.
　Results: The mean and maximum follow-up period was 1.96 years and 5.96 years, respectively, and there were 1,424 data items. The learning rate for changing, emptying, and ordering an ostomy pouch in year 2 after ostomy construction was 0.69（95% confidence interval（CI）: 0.58-0.78）, 0.93（CI: 0.81-0.97）, and 0.50（CI: 0.40-0.59）, respectively. The hazard ratio was significantly lower for elderly patients with a low preoperative ADL.
　Conclusion: The acquisition of voiding management skills was negatively affected by age and preoperative ADL.

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　Background: The present study examined the effectiveness of a continence self-management program in improving lower urinary tract symptoms and voiding behavior.
　Method: The present study was a multicenter, prospective cohort study. The measurement points were catheter placement（T1）, catheter removal（T2）, and discharge or one month after catheter removal（T3）. Lower urinary tract function and independence of urination behavior were assessed using a scoring system developed by the Japanese Society of Wound, Ostomy, and Continence Management.
　Results: Compared with the control group（n=151）, the mean age, proportion of bedridden patients, and mean duration of catheterization were higher in the intervention group（n=86, p<0.01）. On univariate analysis, the score for lower urinary tract function decreased between T2 and T3 among patients with colon, rectal or gynecological disease regardless of whether they received Miles's surgery/lower anterior resection（p<0.001）. Multiple regression analysis revealed that the continence self-management program tended to be associated with improvement of the lower urinary tract function score among patients who received pelvic organ surgery（odds ratio［95% Confident interval］: 3.54［0.88-16.96］） while this relationship was not observed in patients with orthopedic or cerebrovascular disease.
　Conclusion: The continence self-management program may be effective in improving lower urinary tract symptoms among patients with pelvic organ surgery.

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