[Cutaneous vesicostomy in children].
OBJECTIVE
In this report we assessed the results obtained with cutaneous vesicostomy for the temporary diversion of urine in small children.


METHODS
We analyzed the medical records of 20 patients (17 boys and 3 girls) that underwent this type of diversion at our institution. Cutaneous vesicostomy was done due to severe hydronephrosis with low renal function and/or urinary tract infection with metabolic acidosis.


RESULTS
The urinary tract anomalies were posterior urethral valves in 12 children, vesicoureteral reflux in 7 and anterior urethral valve in one. Elevated levels of serum urea and creatinine were found in 16 patients during pre-operative evaluation. During the follow-up there was a reduction of hydronephrosis in all patients, and 5 progressed to chronic renal failure. These patients had worse development of weight and body lenght when compared to those with normal renal function. The post-operative complications were prolapse in 2 patients and stenosis of the stoma in 2.


CONCLUSIONS
cutaneous vesicostomy has proved to be an useful form of urinary diversion. In our experience it is an effective and easily reversible temporary treatment for infants and children with severe hydronephrosis associated with urinary tract infection due to infravesical obstruction or vesicoureteral reflux.
Tucci
S
S
Depto. de Cirurgia, Ortopedia e Traumatologia do Hosp. das Clínicas da Faculdade de Medicina de Ribeirão Preto, USP.
Facincani
I
I
Beduschi
M C
MC
Franco
P B
PB
Martins
A C
AC