Vesicostomy in Nigeria

What is vesicostomy?

During a vesicostomy, a small opening called a stoma, is created in the stomach as an alternative drainage for the bladder to pass urine. The procedure is often employed when a child suffers some types of severe bladder defects and other treatment options have failed.  A vesicostomy is usually done in babies and very young children as a temporary measure to drain urine from the bladder to protect the kidneys.

When would a vesicostomy be needed?

Usually, getting a vesicostomy is based on a doctor’s recommendation, when other alternatives have been explored and failed. Vesicostomy may be recommended when a person cannot urinate normally due to an obstruction or other medical conditions that affect the bladder's ability to function properly.

These obstructions can be caused by varying number of conditions including- a spina bifida, a neural tube defect that affects the spinal cord and the bones of the spine (vertebrae), or a spinal cord injury. These conditions can cause urine to back up in the bladder and potentially damage the kidneys. In these cases, a vesicostomy can help divert urine out of the bladder and prevent further damage to the kidneys.

How is vesicostomy done?

Here are the general steps involved in a vesicostomy procedure:

1. Anaesthesia is induced to ensure that the patient is comfortable and still during the procedure. The surgeon then makes a small incision in the lower part of the child's abdomen to access the bladder.
2. A small portion of the bladder wall will be removed to create an opening, then a small tube called a catheter, will be inserted into the stoma to allow urine to drain out of the body.
3. The stoma will be secured to the skin with sutures or special adhesive and the incision will be closed with sutures or staples, and the child will be taken to a recovery room to wake up from the anesthesia.

After the procedure, the child will need to wear a special pouch or diaper to collect the urine that drains from the stoma. The stoma will need to be cleaned regularly to prevent infection.

What are some post-surgical complications to look for after Vesicostomy?

As with any surgical procedure, there are risks and potential complications associated with a vesicostomy. Here are some of the possible complications of a vesicostomy:

1. Infection: There is a risk of infection at the site of the stoma, which can be prevented with proper care and hygiene.
2. Blockage of the stoma: The stoma can become blocked by blood clots, mucus, or other debris, which can lead to pain and discomfort.
3. Urinary leakage: In some cases, the stoma may not seal properly, leading to urinary leakage and skin irritation.
4. Skin irritation: The skin around the stoma can become irritated by urine, which can lead to redness, itching, and discomfort.
5. Bleeding: There is a risk of bleeding during the procedure, and in rare cases, the stoma may bleed after the procedure.
6. Scarring: The incision site may develop scars, which can be unsightly and uncomfortable.
7. Psychological effects: Some children may experience anxiety, embarrassment, or social isolation due to the stoma and the need to wear a pouch or diaper.

Most children usually do very well once the opening is in place. Some may need additional diaper rash ointment if the skin is irritated by urine. Some children may require a larger diaper to be sure the opening is properly covered and their clothes do not get wet.

A small part of the bladder may come out through the opening during a bowel movement. If the bladder does not go back in after the bowel movement, it can be pushed back in gently. If doesn’t go back in, inform the doctor right away.

FAQs on Vesicostomy

How much time does Vesicostomy surgery takes?

The surgery takes about one hour. The Child is then shifted to recovery room where they can spend one or two hours. A child may usually stay in hospital for two or three days after surgery for observation and full recovery.

Is Vesicostomy surgery painful ?

The doctor will normally prescribe pain relieving medication through IV line. As the child recovers, they may be given oral medication to manage the pain. Once the child is ready to leave the hospital, they may not require any medication for pain.

Is vesicostomy permanent?

Vesicostomy is a temporary bladder drainage solution to reduce the damage to kidney. It is used until the real underlying problem is solved. However, in other cases, it may be a permanent solution if the condition cannot be fully resolved or if it provides the best long-term outcome.

Why is a vesicostomy performed?

Vesicostomy is typically performed in cases where there is a blockage or dysfunction in the lower urinary tract, such as in children with neurogenic bladder or urinary reflux. It provides a temporary or permanent solution to divert urine and relieve pressure on the bladder.

How is a vesicostomy procedure performed?

The procedure is usually performed under general anesthesia. A small incision is made in the lower abdomen, and a portion of the bladder is brought to the surface. The stoma is created, and the edges are sutured to the abdominal wall. A catheter may be placed to keep the stoma open during healing.

How is the stoma cared for?

The stoma should be kept clean and dry. Regular cleaning with mild soap and water is usually recommended. Specialized stoma care products, such as ostomy bags and skin barrier creams, can help protect the surrounding skin and collect urine.

Can a person with a vesicostomy lead a normal life?

Yes, with proper care and management, individuals with a vesicostomy can lead active and fulfilling lives. They can participate in regular activities, including sports and social events while taking precautions to protect and maintain the stoma.Consult our Specialist Doctor NOW!!

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