Vesicostomy

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

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What is a Vesicostomy?

A vesicostomy is an opening created in the lower abdomen (below the umbilicus) that allows urine to drain continuously from the bladder. The opening is created by making a small cut through the skin and into the bladder during the surgical procedure. A small part of the wall of the bladder is then turned inside out and sutured into the abdomen. The small opening would look like a small slit with reddish tissue around.

Who needs a Vesicostomy?

Often, children who will need this procedure are infants and toddlers who may have been born with an obstruction (blockage) anywhere in the urinary tract. This may occur in children who have been diagnosed with posterior urethral valves, vesicourethral reflux or spina bifida and other genito-rectal abnormalities. The main purpose of the procedure is to prevent urinary tract infections and prevent urine from going back into the kidneys and causing damage.

Following surgery, your child:

  • Will have an intravenous drip for fluid replacement, this will be removed as soon as your child is drinking well.
  • Will be assessed for pain and given analgesia to relieve any pain, discomfort and/or nausea following the surgery.
  • May have blood-stained urine draining from the vesicostomy in the first few days following the operation, this is normal and usually settles as soon as your child is drinking normally.
  • May require an overnight hospital stay following the surgery.
  • May have a small catheter in the new opening (vesicostomy) for 2-3 days, some surgeons remove it after 1 day.
  • May have urine draining from the vesicostomy directly into your child’s nappy, if the vesicostomy is still needed when your child is older (about 2 years old), a urine collection bag may be used so the child is kept dry and comfortable. The Clinical Nurse Consultant for Stomal Therapy will assist with this.

How do I care for my child’s Vesicostomy at home?

  • Nappies should be checked regularly and changed when wet to prevent skin damage around the vesicostomy. Urine generally does not cause skin problems, but occasionally the skin may become red, irritated and sore. If this happens, the skin needs to be treated with ointments or barrier creams. Thrush (a fungal infection) may also occur as a result of constant skin exposure to the urine. An anti-fungal cream may need to be prescribed by your local doctor to treat the infection.
  • Your child may have a bath or a shower about 2 days after the operation.

Call your doctor or Clinical Nurse Consultant for Stomal Therapy if:

  • urine does not drain from the vesicostomy for more than 2 hours
  • urine coming from the vesicostomy changes in smell as this may indicate an infection
  • your child develops a fever greater than 38.5 0 C
  • there is blood in the urine
  • the skin around the vesicostomy looks red, crusty, inflamed or irritated
  • the stoma tissue protrudes out more than the usual and looks different

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Kids Health (CHW)
The Children's Hospital at Westmead
Tel: (02) 9845 0000
Fax: (02) 9845 3562
www.chw.edu.au
Sydney Children's Hospital, Randwick
Sydney Children's Hospital, Randwick
Tel: (02) 9382 1688
Fax: (02) 9382 1451
www.sch.edu.au
Kaleidoscope, Hunter Children's Health Network
Kaleidoscope Children Young People and Families Network
Tel: (02) 4921 3670
Fax: (02) 4921 3599
www.kaleidoscope.org.au