Vesicostomy: An alternative approach for complicated adult patients with urinary retention

Purpose:

Patients with permanent urethral catheterization for chronic urinary retention frequently experience several complications, such as bladder stones and/or urinary tract infections. In this study, we performed vesicostomy in adult patients with urinary retention who developed complications during long-term indwelling catheterization.

Methods:

Patients with a permanent bladder catheter for urinary retention, and bladder stones and/or urinary tract infection between April 2019 and October 2021 were enrolled in this retrospective study. Vesicostomy and additional surgeries, such as vesicolithotomy, were performed if necessary. Residual urine volume was measured with computed tomography 7 days after the operation. We followed-up all patients 3 months postoperatively to identify complications.

Results:

Nine patients were included in this study; eight were male and one was female. The median age at operation was 65 (range, 23–92) years. Concurrent operations were lithotomy in five, cystostomy closure in one, removal of a bladder foreign body in one, and nephrectomy in one. The postoperative median residual urine volume in the bladder was 32 (range, 5–51) ml. Perioperative complications comprised delirium (Clavien–Dindo grade II) in two patients and stomal bleeding (Clavien–Dindo grade II) in one patient. There were no complications of bladder stones, febrile urinary tract infection, or stomal stenosis postoperatively.

Conclusions:

Vesicostomy for adult patients with urinary retention was useful and safe. Our results suggest that vesicostomy could be a bladder drainage option for select adult patients who are not candidates for permanent indwelling catheterization.