Cutaneous vesicostomy for palliative management of hemorrhagic cystitis and urinary clot retention.
We present the case of a 9 year old boy with hemorrhagic cystitis and urinary clot retention in the setting of chemotherapy refractory pre-B cell acute lymphocytic leukemia. The patient was undergoing palliative care which was complicated by severe discomfort from urinary clot retention. The decision was made to perform a cutaneous vesicostomy for clot removal and urinary drainage given the goals of care. The patient tolerated the procedure well and was comfortable with no further urinary tract symptoms until he expired. Cutaneous vesicostomy should be considered as an effective surgical option for severe clot retention in children.
Ritch
Chad R
CR
Department of Urology, Division of Pediatric Urology, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. cr2314@columbia.edu
Poon
Stephen A
SA
Sulis
Maria Luisa
ML
Schlussel
Richard N
RN
D002648:Child; D003556:Cystitis / Q000150:complications*; D003559:Cystostomy; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D008297:Male; D010166:Palliative Care; D012867:Skin; D013927:Thrombosis / Q000150:complications*; D016055:Urinary Retention / Q000150:complications* / Q000209:etiology / Q000601:surgery*