Vesicostomy Care
Explanation | Care | Dilating a vesicostomy | When to call the Dr.
What is a vesicostomy?
A vesicostomy is an opening in the abdomen that allows urine to drain continuously from the bladder. The opening is made by making a small incision (cut) through the skin and into the bladder during a surgical operation. A small part of the wall of the bladder is turned inside out and sewn to the abdomen. There will not be a gaping hole in the abdominal wall. The opening instead looks like a small slit surrounded by some pink tissue.
Most often children who need this procedure are very young -- usually infants and toddlers. Children may have been born with an obstruction (blockage) somewhere in the urinary tract. This may occur in children who have been diagnosed with posterior urethral valves, cloacal anomalies, vesicoureteral reflux or spina bifida.
This procedure is a necessary step for some children to help prevent urinary tract infections and/or kidney damage. Although most children who need a vesicostomy are young (under 5 years old), sometimes this procedure also helps older children or teenagers temporarily.
How do I care for my child's vesicostomy at home?
The opening of the vesicostomy will naturally shrink down if it is not stretched at regular intervals. It is necessary to dilate the opening with a catheter twice a day. It is best to do this in the morning and again in the evening before bedtime. Urine should continuously drain through the vesicostomy opening, called a stoma. It is normal for a slight amount of bleeding to occur from the stoma during dilation.
All patients who have a vesicostomy need to wear a diaper or incontinence brief. Urine draining from the vesicostomy into a diaper or incontinence brief generally does not cause skin problems. Occasionally, however, skin may become red, irritated and sore. If this happens, the skin may need to be treated with ointments or other medicine.
Dilating a vesicostomy
- Wash your hands with soap and water.
- Clean the area surrounding the vesicostomy with Betadine" swabs. Clean in a circular fashion around the site with 3 different swabs wiping from the center outward.
- Apply water soluble lubricant to the catheter.
- Insert the catheter into the vesicostomy opening (stoma) approximately 1/2-1 inch. You will feel resistance when you bump the back of the bladder.
- Turn the catheter back and forth to dilate the stoma.
- Remove the catheter from the stoma.
- Resterilize the catheter after use.
Call your child's doctor
- If urine doesn't drain from the vesicostomy for 2 hours
- If the skin around the stoma site looks red, crusty, irritated or infected
- If you are unable to pass the catheter through the stoma to dilate it
- If a portion of tissue protrudes from the stoma
- If it is painful for the catheter to be passed through the vesicostomy
- If urine develops a bad odor
- If there is blood in the urine (more than the usual amount that occurs with the dilation)
- If a fever greater than 101.5°F (38.6°C) develops
Contact Us
For additional information on this or any Health Topic, please call the Family Resource Center, 513-636-7606, or your pediatrician.
Patient Education Program II 2105 12/97
Rev. 8/06
