Continent catheterizable vesicostomy in adults: Initial experience at a Scandinavian tertiary referral centre

Abstract

Objective. The aim of this study was to present the initial experience of continent catheterizable vesicostomy at a Scandinavian tertiary referral centre. Material and methods. Eleven patients, on average 47 years old, with various severe lower urinary tract dysfunctionalities or complete urethral obliteration, underwent reconstruction with a continent catheterizable vesicostomy between 2004 and 2011, with a mean follow-up of 48 months. Results. For eight patients the first reconstructive attempt was successful. Three patients required more than one operation to become continent and to be able to catheterize easily. Two patients had previously been subjected to bladder neck closure and two had complete urethral obliteration, but no patient in this series had undergone bladder neck closure simultaneous to the vesicostomy procedure. Conclusions. For patients who find it difficult to perform self-catheterization via the native urethra, or with an obliteration of the prostatic/membranous/bulbar urethra, construction of a continent catheterizable vesicostomy may be a feasible treatment option. The need for revision is noteworthy. Despite severe difficulties in a few of the patients in the present series, necessitating reoperations, all patients were finally satisfied with the procedure.

Key Words::

• bladder augmentation
• continent
• urethral obliteration
• vesicostomy

Acknowledgements

This work was supported by Anna-Lisa and Bror Björnssons Research Foundation and Sahlgrenska University Hospital project number ALF 7582. Gustav Peeker is gratefully acknowledged for his schematic drawings. I am indebted to Mrs Elisabeth Ståhlgren for, as always, excellent secretarial assistance and flawless linguistic revision. Very unexpectedly and sadly, she became ill and died during the final preparation of this paper – I dedicate this manuscript to Elisabeth.

Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.