What is vesicostomy?

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Vesicostomy in children: Overview

A vesicostomy is surgery to make an opening for urine to travel from the bladder out of the body. This opening is called a stoma. It's made through the skin on the belly. It looks like a small, narrow slit in the skin below the belly button.

This kind of surgery is done when a child has a problem draining urine from the bladder in the usual way. The doctor makes a stoma so urine can leave the body. This new way of passing urine is usually temporary. Your doctor will talk to you about how long your child will need it.

Your child will be asleep during the surgery. The doctor makes a cut in your child's lower belly and in the bladder. The cuts are called incisions. The doctor then attaches a small part of the bladder wall to an opening in the skin of the lower belly. After that, urine can leave the body through the stoma.

Most children go home 1 or 2 days after surgery. Your child will probably be able to go back to school or day care in about 1 week.

After surgery, urine should flow freely from the stoma. This will not hurt or be uncomfortable for your child. Your child will need to wear a diaper that covers the stoma. Your doctor or nurse will teach you how to care for your child's stoma.

How can you care for your child after a vesicostomy?

Activity

  • Allow your child to slowly become more active. Have him or her rest as much as needed. Make sure your child gets enough sleep at night.
  • If your child is old enough to walk, have him or her try to walk each day. Bit by bit, increase the amount your child walks. Your child may climb stairs. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Your child may shower. Pat the stoma dry. Your child should not take baths unless the doctor says it is okay.
  • Do not allow your child to swim or go in hot tubs unless the doctor says it is okay.
  • If your child goes to school or day care, he or she may return when he or she is ready. This is usually in about 1 week.
  • Do not allow your child to do strenuous activity for about 4 to 6 weeks, or until your doctor says it is okay. This includes riding bikes, playing running games, wrestling, and taking part in gym class.
  • Your child may ride in the car with the car seat straps in their usual position.

Diet

  • Your child can eat his or her normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Have your child drink plenty of fluids.
  • You may notice a change in your child's bowel habits right after surgery. This is common. If your child has not had a bowel movement after a couple of days, call the doctor.

Medicines

  • Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.
  • The doctor may give your child medicine for bladder spasms. Have your child take it as directed.
  • Make sure that your child takes pain medicines exactly as directed.
    • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
    • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
  • If you think pain medicine is making your child sick to his or her stomach:
    • Give your child the medicine after meals (unless the doctor has told you not to).
    • Ask your child's doctor for a different pain medicine.
  • Your doctor may prescribe antibiotics. Have your child take them as directed. Do not stop giving them to your child just because he or she feels better. Your child needs to take the full course of antibiotics.

Stoma care

  • Wash the area around the stoma daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing.
  • Keep the area clean and dry.
  • Your doctor or nurse will give you instructions about how to care for the stoma.

How do you prepare for your child's vesicostomy?

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

  • Talk to your child about the surgery. Tell your child it will help urine leave your child's body. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
  • Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
  • Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

  • A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
  • Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

After your child's vesicostomy: When to call

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child passes out (loses consciousness).
  • Your child has sudden chest pain and shortness of breath, or coughs up blood.
  • Your child has severe trouble breathing.

Call your doctor now or seek immediate medical care if:

  • No urine has drained from your child's stoma in over 2 hours.
  • Your child is sick to his or her stomach or cannot keep down liquids.
  • Your child has pain that does not get better after he or she takes pain medicine.
  • Your child has a fever of 100.4°F or higher.
  • Your child has signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • Swollen lymph nodes in his or her neck, armpits, or groin.
    • A fever.
  • Your child's stoma pulls inward, or the edges separate from the skin.
  • Your child's stoma bulges out, or there is a bulge under the skin around the stoma.
  • Your child has new back pain. The pain may be just below the rib cage, on one side. This is called flank pain.
  • Your child's urine smells bad or looks cloudy or discolored.

Watch closely for any changes in your child's health, and be sure to contact your doctor if:

  • Your child refuses to drink fluids.

After your child's vesicostomy: Overview

Vesicostomy is surgery to make an opening through the skin on the belly to the bladder so that urine can drain out of the body. This surgery is done when a problem prevents urine from draining out of the bladder. A vesicostomy usually is temporary. Your doctor will talk to you about how long your child will need it.

Your child may be more tired than usual for several days. Your child's belly may be sore where the doctor made the opening (stoma) between the bladder and the belly. The soreness usually goes away in a few days.

Most children can go back to school or day care in about 1 week.

Your child will need to wear a diaper that covers the stoma to absorb the urine. Your doctor or a nurse who specializes in taking care of stomas will teach you how to care for your child's stoma.

What happens on the day of your child's vesicostomy?

  • Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the surgery may be canceled. If the doctor told you to have your child take his or her medicines on the day of surgery, have your child take them with only a sip of water.
  • Have your child take a bath or shower before you come in. Do not apply lotion or deodorant.
  • Your child may brush his or her teeth. But tell your child not to swallow any toothpaste or water.
  • Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
  • Be sure your child has something that reminds him or her of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

  • A parent or legal guardian must accompany your child.
  • Your child will be kept comfortable and safe by an anesthesia provider. Your child will be asleep during the surgery.
  • The surgery will take about 1 hour.
  • After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery room staff will monitor his or her condition. The doctor will talk to you about the surgery.
  • You will probably be able to take your child home in 1 to 2 days.
  • Your child will have a bandage over the stoma.
  • Your child may have a tube that drains urine from his or her bladder. This is called a urinary catheter. The tube may be in your child's stoma. Or it may be in the urethra. The urethra is the tube that normally carries urine from the bladder to outside the body. The catheter will be removed before your child leaves the hospital.

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