Button Cystostomy: Is it really a Safe and Effective Therapeutic Option in Paediatric Patients with Neurogenic Bladder?

To define safety and effectiveness of cystostomy button in the management of bladder drainage in paediatric patients with neurogenic bladder, and report our personalized surgical technique.

Retrospective analysis of patients undergoing cystostomy button placement for bladder drainage from October 2009 and December 2015. Endoscopic and open surgical techniques and median term complication was analysed and indication were recorded.

Thirty five patients, 16/35 (45.7%) females and 19/35 (54.3%) males underwent cystostomy button placement for bladder drainage with a mean age of 8.6 ± 4,8 years standard Deviation (SD) and a mean follow up time of 37 months. 91.4% of patients had a neurogenic bladder; a non-obstructive urinary retention was diagnosed in the remainder of cases. A medium term complication was mostly represented by urinary tract infection observed in 10/35 patients that was the most representative cause of button removal (4/35). Other observed complications were button leakage (n=2), decubitus (n=1) and bladder stone (n=1). No post-operative complication was observed and no differences were found in term of complications in the two performed surgical approach.

Cystostomy button is a safe and effective treatment for bladder drainage in neurogenic paediatric patients and, it is also well accepted, by patients and caregivers. Cystostomy button should be considered an alternative method to the other bladder drainage, which may avoid mechanical concerns and most of the social discomfort.

Urology. 2016 [Epub ahead of print]

Giovanni Mosiello, Ana Ludy Lopes Mendes, Maria Luisa Capitanucci, Antonio Maria Zaccara, Mario De Gennaro

Neuro-Urology Clinical and research unit, Paediatric Hospital Bambino Gesù, Rome, Italy; Robotic surgery and Urodynamic Unit, Paediatric Hospital Bambino Gesù, Rome, Italy., Neuro-Urology Clinical and research unit, Paediatric Hospital Bambino Gesù, Rome, Italy; Robotic surgery and Urodynamic Unit, Paediatric Hospital Bambino Gesù, Rome, Italy. Electronic address: ., Robotic surgery and Urodynamic Unit, Paediatric Hospital Bambino Gesù, Rome, Italy.

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