Faculty Collaboration Database

Vesicostomy revisited: the best treatment for the hostile bladder in myelodysplastic children? BJU Int 2005 Aug;96(3):397-400

Date

07/27/2005

Pubmed ID

16042737

DOI

10.1111/j.1464-410X.2005.05638.x

Scopus ID

2-s2.0-23244434606 (requires institutional sign-in at Scopus site)   47 Citations

Abstract

OBJECTIVE: To evaluate the effects of vesicostomy on the urinary tract of myelodysplastic children in whom conservative bladder management with clean intermittent catheterization (CIC) has failed to preserve upper and lower urinary tract function.

PATIENTS AND METHODS: Sixteen children with myelodysplasia underwent vesicostomy. Indications included worsening hydronephrosis, vesico-ureteric reflux (VUR), recurrent urinary tract infections (UTIs), and increasing renal insufficiency despite CIC and/or difficulty with CIC. The mean (range) age at vesicostomy was 36.5 (9-82) months and the follow-up 7.4 (2-16) years.

RESULTS: Hydronephrosis resolved or improved in 12 of 14 children, the incidence of UTI decreased to one or fewer per year in 10, VUR resolved or improved in nine, and renal function improved or stabilized in six of seven patients. One patient initially presented with renal insufficiency and subsequently required dialysis despite vesicostomy. Complications occurred in three of 15 children, and included stomal stenosis and bladder calculi. The vesicostomy was closed in six patients after a mean of 4.4 (1.5-9) years. Four of these patients required concomitant bladder augmentation.

CONCLUSIONS: Vesicostomy in myelodysplastic children is effective in preventing and/or resolving the deleterious consequences of a 'hostile' bladder. The procedure is uncomplicated, well tolerated, reversible and should be considered in managing children in whom conservative management by CIC has failed.

Author List

Morrisroe SN, O'Connor RC, Nanigian DK, Kurzrock EA, Stone AR

Author

Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Child, Preschool
Cohort Studies
Cystostomy
Female
Humans
Hydronephrosis
Infant
Male
Retrospective Studies
Spinal Dysraphism
Treatment Outcome
Urinary Bladder, Neurogenic
Urinary Tract Infections
Vesico-Ureteral Reflux