What Are Some Indications for a Vesicostomy?

Discussion A cutaneous vesicostomy is an incontinent diversion of the bladder to the external abdominal wall usually below the umbilicus that maintains a low-pressure urinary system. The urine drains into a collecting bag or hygiene product such as a diaper. It is usually used as a temporary diversion until bladder function resolves or another treatment can be carried out. However, it can also be used as a permanent diversion in some cases. A vesico-cutaneous fistula is similar but performed slightly differently. It is often intended to be a longer-term diversion procedure and is a continent diversion of the bladder. Some of the conditions treated with a vesicostomy include: Neuropathic bladder due to a brain, spinal cord or muscle problem such as spina bifida Lower urinary tract obstruction e.g. posterior urethral valves Dysfunctional voiding Vesicoureteral reflux Hydronephrosis Congenital megaureter Learning Point Before a vesicostomy is performed other treatments are usually tried such as clean intermittent catheterization (CIC), anticholinergic medications and botulinum toxin injection. If these do not achieve satisfactory results then vesicostomy is considered. CIC is widely used with a low complication rate but it can have bleeding, stricture formation and creation of a false tract. Cholinergic medications may have unwanted side effects (e.g. blurred vision, abdominal pain, constipation, diarrhea, etc.) that cause discontinuation. Botulinum toxin is temporary, usually...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news