Vesicostomy is a simple, well-tolerated, and reversible procedure with few complications
that safeguards upper urinary tract (UUT), decreases VUR grade, decreases UTI, and
preserves renal function and should be considered in patients with PUV who have undergone
prior valve ablation and bladder function not improved, and in myelodysplastic children
that do not respond to catheter drainage [
- Prundente A.
- Reis O.L.
- Franca Rde P.
- Miranda M.
- Levi D’Ancona C.A.
Vesicostomy as a protector of upper urinary tract in long-term follow-up.
- Rouzrokh M.
- Mirshemirani A.
- Khaleghnejad-Tabari A.
- Sadeghian N.
- Mohajerzadeh L.
- Mohkam M.
Protective temporary vesicostomy for upper urinary tract problems in children: a five-year
Intractable high-pressure bladder in female infants with spina bifida: clinical characteristics
and use of vesicostomy.
- Morrisroe S.N.
- O'Connor R.C.
- Nanigian D.K.
- Kurzrock E.A.
- Stone A.R.
Vesicostomy revisited: the best treatment for the hostile bladder in myelodysplastic
We evaluated the temporary vesicostomy as a safeguard of the UUT in children with
bladder outlet obstruction, bladder dysfunction, and high-grade VUR with sepsis and
assessed the possible predictors of the UUT's morphological and functional improvement
since these have been rarely explored in previous reviews.
We evaluated the outcome and complications of temporary vesicostomy who were operated
on 69 children at our center from 2014 to 2019.
There were 63 (91.3%) boys and 6 (8.7%) girls who underwent vesicostomy at a mean
age of 15.38 ± 2.74 months old. Twenty-nine cases (42%) were diagnosed as primary
VUR, 23 (33.3%) had posterior urethral valve (PUV), and 5 (7.2%) had voiding dysfunction,
while 12 (17.4%) were neurogenic bladder. Twenty-five (36.2%) patients were diagnosed
prenatally and the remainder (44, 63.8%) postnatally. All patients were evaluated
at least one year postoperatively. UTI was diagnosed in all cases before vesicostomy;
47 (68.1%) had a single episode of UTI and 22 (31.9%) had recurrent episodes of UTI.
Mean serum creatinine was 1.75 ± 0.13 (0.7–4.8) mg/dl. Serum creatinine and the rate
of UTI significantly improved (p-value <0.01). Seven (10.1%) cases were complicated
with prolapse, 8 (11.6%) with stenosis, and 10 (14.5%) with peristomal dermatitis,
all of them were males.
About 75.4% of cases developed morphological improvement, while 24.6% of cases not
improved (p-value = 0.0001). Improvement or stability of glomerular filtration rate
(GFR) was seen in 84.1%, while 15.9% deteriorated GFR (p-value = 0.0001). This deterioration
is associated with prenatal renal dysplasia. Age less than one year, abdominal swelling,
severe HUN, grade V VUR and recurrent UTI before vesicostomy all independently affect
functional improvement after vesicostomy.
Vesicostomy is a simple, reversible, and well-tolerated surgery with few complications
that is indicated in children with bladder outlet obstruction, bladder dysfunction,
and high-grade VUR to protect UUT, improve renal function, decrease VUR, hydronephrosis,
and febrile UTI. Age less than one year, abdominal swelling, severe HUN, grade V VUR
and recurrent UTI before vesicostomy all were predictors that independently affect
morphological and functional outcomes after vesicostomy.