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Updated: May 9, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Button vesicostomy: 13 years of experience
Catherine J Bradshaw1, Robert Gray2, Angela Downer1
1Department of Paediatric Surgery, Oxford Radcliffe NHS Trust, Oxford Children's Hospital, Headley Way, Oxford, OX3 9DU, UK.
Insights
Button vesicostomy offers a safe and effective alternative for pediatric bladder drainage when clean intermittent catheterization (CIC) is not feasible. This technique demonstrates minimal morbidity, making it a viable option for various bladder conditions.
Area of Science:
- Pediatric Urology
- Surgical Techniques
Background:
- Button vesicostomy is an emerging alternative for managing pediatric urinary retention.
- It is considered when clean intermittent catheterization (CIC) is challenging due to patient age, sensation, or urethral issues.
Purpose of the Study:
- To review and evaluate the recent clinical experience with button vesicostomy in children.
- To assess the safety and efficacy of this bladder drainage method.
Main Methods:
- Retrospective review of pediatric patients who underwent button vesicostomy insertion between 1998 and 2011.
- Analysis of patient demographics, indications for the procedure, duration of use, and complication rates.
Main Results:
- Thirty children (4 days to 16 years) received button vesicostomy for various conditions including neuropathic, hypotonic, functional, and post-obstruction bladders.
- The median use duration was 11 months, with minor complications in 12 patients and major complications in 5.
- Indications included neuropathic bladders (n=15), congenital hypotonic bladders (n=6), functional bladder disorders (n=5), and post-obstruction bladders (n=4).
Conclusions:
- Button vesicostomy is a safe and suitable short- to medium-term management option for pediatric bladder drainage.
- The procedure is well-tolerated by families due to minimal morbidity.
- It serves as a valuable alternative to CIC, particularly for neuropathic bladders and temporary drainage needs.
Introduction:
Over recent years the button vesicostomy has become an alternative management option in children with poor bladder emptying, when clean intermittent catheterisation (CIC) cannot be initiated for reasons of age, sensation, or urethral anatomy. This study reviews recent experience of this technique and evaluates its use.
Methods:
Retrospective review of patients who had a button vesicostomy to permit bladder drainage between 1998 and 2011.
Results:
Thirty children underwent button vesicostomy insertion aged between 4 days and 16 years. Indications were neuropathic bladders (n = 15), congenital hypotonic bladders (n = 6), functional bladder disorders (n = 5), and post-obstruction bladders (n = 4). The median length of use was 11 months; however, 7 patients still have the button in situ. Minor complications (n = 12) included transient leakage, wound infection, and overgranulation. Major complications included 2 UTIs, 1 device failure, and 2 significant leaks, requiring revision of the tract and removal of the button.
Conclusion:
The button vesicostomy is a suitable and safe technique for use in the short- and medium-term. The procedure has minimal morbidity and therefore is acceptable to families. It has a wide scope, including patients with a neuropathic bladder as an alternative to CIC and where temporary drainage is required until bladder function can recover.
