Continent Catheterizable Vesicostomy: An Alternative Surgical Modality for Pediatric Patients With Large Bladder...

Area of Science:

• Pediatric Urology
• Surgical Techniques
• Bladder Reconstruction

Background:

• Patients with flaccid neurogenic bladder or intractable voiding dysfunction often require urinary diversion.
• Traditional methods may involve the appendix or ileum, which can lead to complications.
• A continent catheterizable vesicostomy offers an alternative for urinary drainage.

Purpose of the Study:

• To describe a modified technique for continent catheterizable vesicostomy in pediatric patients.
• To report the early outcomes of this novel surgical approach.
• To evaluate its efficacy in patients with large capacity bladders and voiding dysfunction.

Main Methods:

• A modified technique involving a tubularized bladder flap intussuscepted into the bladder was performed on six pediatric patients.
• The procedure utilized a Pfannenstiel incision, avoiding intraperitoneal dissection.
• A catheterizable channel was tunneled to the umbilicus.

Main Results:

• The median patient age was 8 years, with various underlying etiologies for urinary dysfunction.
• The median hospital stay was 8 days.
• Five out of six patients achieved successful self-catheterization, with one requiring balloon dilation for stenosis. No major complications were reported.

Conclusions:

• Continent catheterizable vesicostomy is a viable and novel technique for urinary drainage in select pediatric patients.
• This method spares the use of the appendix or ileum.
• Early outcomes are encouraging, demonstrating a functional and continent urinary channel.