What is a vesicostomy?

A vesicostomy is a surgical opening in the bladder to the outside of the body (lower belly) that allows urine to come out, preventing urinary tract infection and damage to the kidneys. Urine drains constantly from this opening. The child will need to wear a diaper, training pants (Pull-Ups), or an incontinence pad. A vesicostomy is sometimes a temporary treatment.

What are some common characteristics of a child with a vesicostomy?

Children who are born with an obstruction that prevents urine from flowing through the urethra are treated with a vesicostomy. Also, children who have bladders that do not work properly, such as some children with spina bifida, may need a vesicostomy as a temporary treatment.

Who might be on the treatment team?

• The primary care provider in the medical home
• A pediatric urologist or nephrologist
• Often, a nurse at the specialist’s office to answer questions related to the vesicostomy

What are some elements of a Care Plan for a child with a vesicostomy?

• The vesicostomy should drain freely into the diaper. Diapers are changed no differently than otherwise.
• Occasionally, the skin around the vesicostomy may become red, irritated, and sore. If so, the child may be prescribed a special medication or ointment to treat the skin.

What adaptations may be needed?

Physical Environment and Other Considerations

• Children with a vesicostomy can have their diapers changed as usual.
• Because staff may feel uncomfortable with an opening in the child’s belly, plan an in-service training for all staff to promote comfort with the vesicostomy.

What should be considered an emergency?

• Urine does not drain from the opening for 2 hours.
• The skin near the opening looks red, crusty, or infected.
• Tissue protrudes from the opening.
• Bleeding from the opening.
• A fever higher than 101.5°F (38.6°C).

What types of training or policies are advised?

• Standard handwashing procedures
• In-service training on vesicostomy and looking for concerning signs

What are some resources?

• Cincinnati Children’s: “Vesicostomy Care,” www.cincinnatichildrens.org/health/v/vesicostomy
• St. Louis Children’s Hospital: “Vesicostomy,” www.stlouischildrens.org/our-services/urology-services/vesicostomy
• The Hospital for Sick Children AboutKidsHealth: “What is a vesicostomy?,” www.aboutkidshealth.ca/En/HealthAZ/TestsAndTreatments/Procedures/Pages/Vesicostomy.aspx

Source: Managing Chronic Health Needs in Child Care and Schools: A Quick Reference Guide.

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