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08:50 - 09:00
ESPUN S2-4
(O)
EXPERIENCES OF VESICOSTOMY BUTTONS IN CHILDREN
Monika DOROSZKIEWICZ
1
, Malin LEIDZÉN
2
and Gundela HOLMDAHL
3
1) The Queen Silvia Children's Hospital, Urotherapy, Göteborg, SWEDEN - 2) The Queen Silvia Childrens Hospital,
Göteborg, SWEDEN - 3) The Queen Silvia Chuldrens Hospital, Urology unit, Göteborg, SWEDEN
PURPOSE
To present our experiences using vesicostomy buttons on children with severe bladder dysfunction
MATERIAL AND METHODS
Sixteenen children, 5 girls and 11 boys, age 22 months-17.3 years have had a vesicostomy button inserted at our
institution during the period of June 2012 to March 2015. All of them have had a suprapubic line for a period of about
one month before the button. We use a protocol for follow up: including registration of indications, size of the button,
date and need of sedation for button change and complications.
RESULTS
Indication included bladder dysfunction due to neurogenic bladder, posterior urethra valves with polyuria, bladder
exstrophy and bladder dysfunction associated with VUR. Until now, the average duration of use was 11.9 months (1m-
27m). We used Fr14 for 15/16 children. The latest patient had an Fr12 because it is easier to insert and hopefully
irritates the abdominal wall less. The length of the button 2.5cm to 4 cm. All buttons were changed at the hospital by
the urotherapist, 4 needed anestethia the first time and many of the children are sedated with nitrous oxide or
midazolam. We changed the button with about 3 months (2-4m) intervals. Four patients removed the button because of
changed clinical situations; one got a Mitrofanoff stoma, 2 patients had a succesful bladder rehabilitation, one patient
with polyuria had no need of the button after TX. One boy with spinal tumour died.
Minor complicationsoccured including local infection (n=39, granulomas (n=5), UTI (n=3), muddy urine (n=29),
obstruction of the button (n=1). No one had problems of leakage.
CONCLUSIONS
Minor complications occurs. Vesicostomy buttons are useful för bladder drainage and are well accepted by children and
their parents. It is a good alternative to a suprapubic line, when CIC through urethra is impossible and there is not yet
clear indication of Mitrofanoff.