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Cutaneous vesicostomy in infancy

J Mandell, S B Bauer, A H Colodny

    The Journal of Urology
    |July 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

    Cutaneous vesicostomy effectively improved upper urinary tract drainage in infants with lower urinary tract dysfunction. This simple, reversible procedure offered significant benefits for children with conditions like myelodysplasia.

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    Area of Science:

    • Pediatric Urology
    • Nephrology
    • Surgical Management

    Background:

    • Hydroureteronephrosis in infants and young children often stems from lower urinary tract dysfunction.
    • Neurogenic bladder due to myelodysplasia and severe vesicoureteral reflux with sepsis are common etiologies.
    • Effective management of upper urinary tract dilatation is crucial for long-term renal health.

    Purpose of the Study:

    • To evaluate the efficacy of cutaneous vesicostomy in managing hydroureteronephrosis in pediatric patients.
    • To assess the impact of cutaneous vesicostomy on upper urinary tract drainage and appearance.
    • To determine the role of cutaneous vesicostomy as a reversible treatment for lower urinary tract dysfunction.

    Main Methods:

    • Cutaneous vesicostomy was performed on 10 pediatric patients with hydroureteronephrosis.

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  • Patients had underlying conditions including neurogenic bladder secondary to myelodysplasia (8 cases) and severe vesicoureteral reflux with urinary sepsis (2 cases).
  • Follow-up included assessment of upper urinary tract drainage and appearance, with subsequent vesicostomy closure when appropriate.

    • Main Results:

    • All 10 children demonstrated marked improvement in upper urinary tract drainage and appearance post-vesicostomy.
    • The procedure was effective in managing the dilatation associated with the underlying lower urinary tract issues.
    • Vesicostomy closure was successfully performed in cases where alternative management strategies became more suitable.

    Conclusions:

    • Cutaneous vesicostomy is an effective, simple, and reversible treatment option for selected infants and young children with hydroureteronephrosis due to lower urinary tract dysfunction.
    • It provides significant improvement in upper urinary tract status, offering a valuable temporary or definitive solution.
    • The reversibility of the procedure allows for adaptation of management strategies as the child's condition evolves.