Intermittent voiding per urethra as an indicator of cutaneous vesicostomy malfunction

[CLINICAL OUTCOMES OF CUTANEOUS VESICOSTOMY IN PEDIATRIC UROLOGICAL DISEASES]

(Introduction & objective) We aimed to evaluate the validity and complications of cutaneous vesicostomy retrospectively. (Material & methods) We reviewed the charts of 28 patients (9 male, 19 female) who underwent cutaneous vesicostomy between 2003 and 2017 at our center. The validity of the cutaneous vesicostomy was evaluated by estimating the incidence of febrile urinary tract infection (UTI) before and after the operation using the person years method. To estimate the occurrence of complications, the rates of adverse events and reoperation were summed. (Results) The preoperative and postoperative incidence rate of febrile UTI decreased from 0.058 times/person-years to 0.012 times/person-years, and this decrease was statistically significant (p<0.001). Six (21.4%) patients developed mucosal prolapse of the bladder, which was the most common complication. Most of the patients had refractory constipation. Three patients with mucosal prolapse and 2 with stenosis required repeat vesicostomy by the Lapides technique, after which there was no relapse. (Conclusions) Cutaneous vesicostomy could significantly reduce the incidence rate of febrile UTI. Severe constipation was considered as a risk factor for prolapse.