✦ Posterior Urethral Valve Treatment

Vesicostomy (Blocksom's)

Q: When is the vesicostomy closed?

Vesicostomy is closed at the same time as valve ablation — typically when the baby is large enough for a paediatric urethroscope, usually at 2–6 months.

Q: How is the vesicostomy managed at home?

The vesicostomy opens in the lower abdomen; urine drains into nappies; parents are taught stoma care and signs of blockage before discharge.

Q: Does vesicostomy affect bladder function long-term?

Bladder function is generally preserved; some children develop an overactive or poorly compliant bladder requiring urodynamic assessment post-closure. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Temporary Bladder Diversion for PUV in Very Small or Premature Neonates

30–45 min PROCEDURE

2–4 Days HOSPITAL STAY

>95% SUCCESS RATE

1–2 Weeks RECOVERY

What is Vesicostomy (Blocksom's)?

Blocksom's Vesicostomy creates a temporary opening between the bladder and the abdominal skin (cutaneous vesicostomy) allowing urine to drain freely without a catheter. It is used in very small or premature neonates with posterior urethral valves who are too small for urethroscopy, or when upper tract diversion is needed while the baby grows. The vesicostomy is easily closed later once valve ablation has been performed. The procedure is performed under general or spinal anaesthesia with a hospital stay of 2–4 Days. Success rates reach >95% in appropriately selected patients at experienced centres.

Premature or very small neonates with PUV not suitable for urethroscopy, or those requiring temporary bladder decompression before definitive valve ablation. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Incision & Access

Small lower abdominal incision; bladder dome identified and delivered to the skin.

Stoma Creation

Bladder dome opened; bladder wall sutured to the skin edges creating a stoma.

Drain Placement

Urine drains freely through the stoma into a nappy or collection appliance.

Growth & Planning

Baby grows and stabilises; valve ablation and vesicostomy closure planned at appropriate size.

Closure

Closure performed by excising the stoma and closing the bladder in layers.

Outcomes

30–45 minDURATION

2–4 DaysHOSPITAL STAY

>95%SUCCESS RATE

1–2 WeeksFULL RECOVERY

Who Needs This Treatment?

→Provides reliable bladder drainage in babies too small for urethroscopy.
→No catheter required — bladder drains freely through the stoma.
→Allows upper tracts to decompress without urethral instrumentation.
→Easily managed with nappies in the neonatal period.
→Reversible procedure — vesicostomy closed at definitive valve ablation stage.
→Protects renal function while baby grows to size for urethroscopy.

"Vesicostomy buys us the most precious commodity in neonatal PUV management — time. It safely decompresses the bladder and upper tracts while the baby grows strong enough for definitive valve ablation."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

When is the vesicostomy closed?+

How is the vesicostomy managed at home?+

Does vesicostomy affect bladder function long-term?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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