Definition, Procedure, Complications, Care, Reversal

Vesicostomy is a surgery, in which an opening is made from bladder to directly outside the body i.e. lower belly area. This opening helps in draining urine to prevent urinary tract infection UTI. It is kind of temporary treatment. Vesicostomy can be performed in infants and children under five years of age and only eligible in following conditions.

• If child is born with bladder outlet obstruction, Vesicostomy helps to drain urine in to diaper.
• If child is suffering from neurogenic bladder, Vesicostomy is recommended.

In adults, Vesicostomy is performed on temporary basis and is removed when infection is completely treated.

Vesicostomy Procedure

Patient have to stay overnight in hospital, and a drip line is injected to maintain fluid replacement and management of pain. A cut is made in lower belly preferably below belly button. A catheter is placed in the opening of bladder which drains urine directly in to diaper or nappy (in children). After Vesicostomy, there may be blood in urine due to cut freshly made. If Vesicostomy is performed in adults, a clear urine collection bag/ system is attached with catheter to collect urine. It is a removable plastic bag which can be removed after it fills up.

Vesicostomy Complications

       
Vesicostomy is a simple and reversible surgical operation. But it also have some unusual complications associated like:

• Opening made in Vesicostomy may become narrow and results in poor drainage of urine. It is normal that Vesicostomy may become narrow due to natural healing process of skin.
• Stenosis may occur due to poor drainage and then dilation or periodic catheterization is performed.
• Bladder tissue may get prolapse due to skin opening made in Vesicostomy. Prolapse may occur due to straining (when child cries or have a bowel movement). Prolapse may extend up to 1 inch and is reversible.

Vesicostomy Care

• Vesicostomy require special care regarding hygiene. Vesicostomy drains urine directly in to diaper and diaper should be changed regularly.
• Poor hygiene may lead to diaper rash to skin in contact with diaper. Ointments and creams are recommended for these rashes.
• The abdominal cut should be avoided from water contact, as excess water contact can cause infection in Vesicostomy. Patent is recommended to take complete rest and avoid walking around.
• If any obstruction occurs in Vesicostomy, it should be replaced because obstructed Vesicostomy will lead to accumulation of urine inside bladder and cause infection.

All these steps should be followed regularly.

Vesicostomy Reversal

Vesicostomy is a temporary surgical operation which is performed when other treatment options regarding urinary tract infections get failed. It is kind of bypass surgery to drain urine directly outside body from bladder. It is performed in children below 5 years of age when they are born with any urinary tract abnormality. These children can have Vesicostomy again and again reversibly whenever they got urinary tract infection. There are many cases of children having Vesicostomy every year reversibly to avoid infections in urinary tract. Any kind of injury may lead to Vesicostomy in adults and can be repeated.