Vesicostomy questions

Editorial Team / Admin · Aug 30, 2005

I have a friend who's 11 year old son is going to have a vesicostomy placed in the near furture. She was wondering if anyone could explain how to maintain it at night - does she have to constantly change him & the bedding, does the urine continually drain or dribble out? Any advice would be most appreciated!

Hello,

Yes, the urine should constantly drain. She probably will be trained to dilate the opening twice daily, a.m. and p.m. before hs. She should be told that a small amout of bleeding is common during this procedure.

I tell the parents of my patients to use a diaper (babes/small children) or an incontinece brief. The urine is normally absorbed with these. The skin may become irritated, however, and can be treated with ointments or other meds.

dbsn00 · Aug 30, 2005

Thank you for the info - she was under the impression that the urine would FLOW all night long & everything would be very wet. Naturally, she's nervous & keeps forgetting to ask the doc a lot of questions!

Editorial Team / Admin · Aug 30, 2005

Your are welcome.

Well, it will definitely drain onto the absorbent padding of the incontinence brief, but, not all over the bedding. Make sure she asks ALL kinds of questions. A child that old will not like the briefs, I know, but, the alternative is not acceptable for them. They/he will get used to it and welcome the brief for a good nights sleep and stay sanitary and less irritating.

Pediatric Critical Care Columnist · Sep 9, 2005

What about using an ostomy appliance? The consistency of the effluent from an ileostomy isn't much "thicker". Just a thought.

Editorial Team / Admin · Sep 9, 2005

What about using an ostomy appliance? The consistency of the effluent from an ileostomy isn't much "thicker". Just a thought.

I have never utilized this. I guess it would be o.k. Not sure about expense. Irritation? Sounds like a good idea......

Pediatric Critical Care Columnist · Sep 9, 2005

Convatec makes a line of ostomy products specifically for kids called Little Ones. They have a two piece urostomy appliance that is drainable and can be connected to a collection system for overnights if the volume is sufficient to need that. The flange is on a Stomahesive wafer that will withstand immersion in the tub for several days without coming off, and the opening can be cut to fit the stoma. There's a valve in the bag to prevent urine from pooling against the skin. The wafer comes in a box of 5 for $25.40, the bags are in a box of 10 with two night drains for $38.60 and a 2 ounce tube of Stomahesive paste costs $12.14. You could probably make that amount of supplies last a month with proper care. Ask the ostomy nurse at your hospital about them.

Editorial Team / Admin · Sep 9, 2005

Convatec makes a line of ostomy products specifically for kids called Little Ones. They have a two piece urostomy appliance that is drainable and can be connected to a collection system for overnights if the volume is sufficient to need that. The flange is on a Stomahesive wafer that will withstand immersion in the tub for several days without coming off, and the opening can be cut to fit the stoma. There's a valve in the bag to prevent urine from pooling against the skin. The wafer comes in a box of 5 for $25.40, the bags are in a box of 10 with two night drains for $38.60 and a 2 ounce tube of Stomahesive paste costs $12.14. You could probably make that amount of supplies last a month with proper care. Ask the ostomy nurse at your hospital about them.

Thanks, janfrn, :balloons:

I am not familiar with that product brand. Available in the U.S.??

I hope the OP comes back to see these suggestions.

Pediatric Critical Care Columnist · Sep 9, 2005

Those products are made by Hollister and the prices I quoted came from a US based web site. We use the Convatec brand of ostomy supplies here in Alberta and I've come to quite like them. The first time I ever saw one in action was after my son's liver transplant and stroke. The PICU nurses put a wafer around his bile-duct t-tube by pulling the t-tube through the center hole then snapped on a bag to collect his peritoneal fluid as it leaked out around the tube. He had already had a bout with cellulitis from the constant drainage and the ward nurses had up till then been unable to quantify his fluid losses. This was the perfect solution. So I too hope the OP reads these posts and tells her friend about them.