• The Journal of urology · Aug 1996

    Case Reports Clinical Trial

    New application of the gastrostomy button for clinical and urodynamic evaluation before vesicostomy closure.

    • F I de Badiola, E D Denes, E Ruiz, C Smith, T Bukowski, and R González.
    • Department of Pediatric Urology, Hospital Italiano, Buenos Aires, Argentina.
    • J. Urol. 1996 Aug 1;156(2 Pt 2):618-20.

    PurposeWe report use of the Bard gastrostomy button to occlude vesicostomy and provide access for intermittent catheterization before closure in children with vesicostomy. Evaluation of bladder function in such children usually relies on radiographic and urodynamic studies, which may fail to predict bladder compliance, emptying and continence after closure.Materials And MethodsButtons were placed before vesicostomy closure in 1 boy with the prune-belly syndrome and 2 girls with cloacal anomalies 2.5 to 10 years old. The patients had undergone vesicostomy using the Blocksom technique soon after birth because of urinary infection, and impairment of bladder emptying and renal function.ResultsWith the button in place bladder emptying, compliance, continence and possible upper tract changes could be evaluated during several weeks. Button coaptation to the vesicostomy was complete with no urine leakage around the device, allowing easy intermittent drainage through its channel. After 4 weeks the buttons did not have any encrustation or lithiasis and patients were free of urinary infection. Vesicostomy was closed in each patient and the period of temporary closure provided by the button was predictive of future bladder behavior.ConclusionsThis new and original application of the gastrostomy button as a temporary vesicostomy closure may be useful to predict the clinical and urodynamic responses of a defunctionalized bladder in patients with vesicostomy who are candidates for urinary undiversion.

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