What is vesicostomy?

A vesicostomy is surgery to make an opening for urine to travel from the bladder out of the body. This opening is called a stoma. It's made through the skin on the belly. It looks like a small, narrow slit in the skin below the belly button.

This kind of surgery is done when a child has a problem draining urine from the bladder in the usual way. The doctor makes a stoma so urine can leave the body. This new way of passing urine is usually temporary. Your doctor will talk to you about how long your child will need it.

Your child will be asleep during the surgery. The doctor makes a cut in your child's lower belly and in the bladder. The cuts are called incisions. The doctor then attaches a small part of the bladder wall to an opening in the skin of the lower belly. After that, urine can leave the body through the stoma.

Most children go home 1 or 2 days after surgery. Your child will probably be able to go back to school or day care in about 1 week.

After surgery, urine should flow freely from the stoma. This will not hurt or be uncomfortable for your child. Your child will need to wear a diaper that covers the stoma. Your doctor or nurse will teach you how to care for your child's stoma.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child it will help urine leave your child's body. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

• A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

Activity

• Allow your child to slowly become more active. Have him or her rest as much as needed. Make sure your child gets enough sleep at night.
• If your child is old enough to walk, have him or her try to walk each day. Bit by bit, increase the amount your child walks. Your child may climb stairs. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Your child may shower. Pat the stoma dry. Your child should not take baths unless the doctor says it is okay.
• Do not allow your child to swim or go in hot tubs unless the doctor says it is okay.
• If your child goes to school or day care, he or she may return when he or she is ready. This is usually in about 1 week.
• Do not allow your child to do strenuous activity for about 4 to 6 weeks, or until your doctor says it is okay. This includes riding bikes, playing running games, wrestling, and taking part in gym class.
• Your child may ride in the car with the car seat straps in their usual position.

Diet

• Your child can eat his or her normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Have your child drink plenty of fluids.
• You may notice a change in your child's bowel habits right after surgery. This is common. If your child has not had a bowel movement after a couple of days, call the doctor.

Medicines

• Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.
• The doctor may give your child medicine for bladder spasms. Have your child take it as directed.
• Make sure that your child takes pain medicines exactly as directed.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
• If you think pain medicine is making your child sick to his or her stomach:
  • Give your child the medicine after meals (unless the doctor has told you not to).
  • Ask your child's doctor for a different pain medicine.
• Your doctor may prescribe antibiotics. Have your child take them as directed. Do not stop giving them to your child just because he or she feels better. Your child needs to take the full course of antibiotics.

Stoma care

• Wash the area around the stoma daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing.
• Keep the area clean and dry.
• Your doctor or nurse will give you instructions about how to care for the stoma.