Cutaneous vesicostomy: a useful form of temporary diversion in children

Urinary diversion is not often required in children. Initial enthusiasm for permanent forms of diversion, especially intestinal conduits, has tempered recently with improved reconstructive techniques and the initiation of intermittent catheterization in the management of neurogenic bladder. However, occasionally, temporary diversion still affords the best means of preserving renal function and allowing ultimate reconstruction in a child with uropathology. In our experience vesicostomy has been a successful and simple procedure for temporary diversion in selected children with vesical or urethral disorders. The technique is simple, tubeless, easy to manage and readily reversible. We have reviewed 24 vesicostomies performed in children at our institution during the last 5 years. The results have been overwhelmingly successful and satisfactory. Cutaneous vesicostomy is our preferred form of diversion in selected children who suffer complications of bladder dysfunction until the potential of the bladder can be determined and a definitive plan of management can be established. The specific surgical technique as well as results and complications are discussed.