Suprapubic vesicostomy buttons: Indications, complications and bladder outcomes

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Bladder Management

Background:

• Vesicostomy button drainage is an alternative to clean intermittent catheterization (CIC) for children with urethral obstruction or neurogenic bladder.
• It offers a continent drainage option, potentially improving quality of life and facilitating toilet training.

Purpose of the Study:

• To evaluate the indications, complications, and long-term bladder functional outcomes of button vesicostomy in a 15-year cohort.
• To assess the efficacy and safety of suprapubic button drainage as a second-line bladder management strategy.

Main Methods:

• Retrospective analysis of 29 children undergoing AMT Mini one gastrostomy button insertion.
• Data collected included demographics, indications for the procedure, complications, and long-term bladder capacity and emptying post-removal.

Main Results:

• No short-term complications were observed in 29 children (mean age 3.5 years).
• Common complications included urinary tract infection (31%), leakage (28%), and blockage (7%).
• At a median follow-up of 10 years, 48% remained on drainage, 21% progressed to Mitrofanoff catheterization, and 31% no longer required the button, achieving good urethral voiding.

Conclusions:

• Suprapubic button drainage is a safe and effective second-line option for children unable to perform CIC.
• The procedure can be temporary, resolving with improved bladder function, or long-term for chronic conditions.
• Button vesicostomy can lead to sustained resolution of bladder dysfunction and improved quality of life.