Experience of cutaneous vesicostomy in infants and children

Kwak, Cheol; Lee, Jong Bouk; Kim, Kwang Myung; Choi, Hwang

Abstract

Cutaneous vesicostomy has been suggested as a useful procedure of temporary urinary diversion that can be performed and reversed easily with low incidence of complication We evaluated postoperative courses in 15 patients who underwent vesicostomy for either lower urinary tract dysfunction or obstruction. The age of the patients at the time of vesicostomy ranged from 8 days to 5.8 years(mean 18 months). The indications for vesicostomy were posterior urethral valves(5), neurogenic bladder(5), urethral stricture(31, vesicoureteral reflux(1) and anterior urethral valves(1). Associated anomalies were congenital heart disease(5), imperforated anus(3), subarachnoidal hemorrhage(1) and multicystic kidney(2). Of the 11 patients with dilated upper tracts preoperatively 10 patients improved significantly after vesicostomy while 1 remained stable. Stomal narrowing and mucosal prolapse as complications occurred in 2 patients, but none of these required surgical correction. The vesicostomy was closed successfully in 8 patients at 12 to 53 months after diversion as a simple procedure. Our experience reveals that vesicostomy is thought to be an effective, simple and easily reversible means of temporary urinary diversion to treat selected conditions in infants and children.