{
    "abstract": "In newborn and infant with functional and/or anatomical lower urinary tract obstruction, the goals of vesicostomy are to achieve a low pressure bladder, an effective bladder drainage and to prevent urinary tract infection and sepsis. Nonetheless, classical vesicostomy is not free from complications. The aim is to describe a surgical technique of button vesicostomy as an alternative of cutaneous vesicostomy.\n13 newborn and infant, age between 14 and 60 days (median 20 days), twelve male and one female, underwent button vesicostomy. Twelve patients were neurologically normal and one with neurogenic bladder. Surgical technique of button vesicostomy differs from the classical one; it does not require bladder cupula mobilization, the botton is inserted into the bladder at the urachus insertion without suturing the bladder mucosa to the skin, creating a vesico-cutaneous fistula.\nButton vesicostomy was found to be safe and effective in 96%. Stabilization of upper urinary tracts was achieved in all cases. Botton vesicostomy has made it possible to undergo intermittent catheterization through the button before closure of the vesicostomy, as well as performing standard urodynamic studies through the urethra to evaluate bladder function during follow-up and providing objective data for proper undiversion. There were no complications. Vesicostomy was closed at a median age of twenty months, combined with reconstructive procedures, when necessary.\nButton vesicostomy has improved the outcome of the classical vesicostomy. It provides an efficient way for lowering the bladder pressure in the absence of complications, making possible to perform urodynamic studies; the evaluation of bladder function is essential prior to the undiversion.\nLa vesicostom\u00eda cl\u00e1sica tiene como objetivos en el reci\u00e9n nacido-lactante con obstrucci\u00f3n funcional/anat\u00f3mica del tracto urinario inferior (TUI): conseguir un TUI de baja presi\u00f3n, drenaje efectivo del TUI y disminuci\u00f3n de la infecci\u00f3n/sepsis urinaria; pero no est\u00e1 exenta de complicaciones (prolapso/estenosis). El objetivo es describir la t\u00e9cnica quir\u00fargica de la vesicostom\u00eda-de-bot\u00f3n y sus resultados como alternativa a la vesicostom\u00eda cut\u00e1nea cl\u00e1sica.\nHemos realizado 13 vesicostom\u00edas-de-bot\u00f3n, en pacientes reci\u00e9n nacidos-lactantes; 12 neurol\u00f3gicamente normales y 1 vejiga neur\u00f3gena. La distribuci\u00f3n por edad-sexo: 14-60 d\u00edas (mediana 20 d\u00edas); 12 varones y 1 ni\u00f1a. La t\u00e9cnica quir\u00fargica de la-vesicostom\u00eda-de-bot\u00f3n difiere de la cl\u00e1sica en que no precisa movilizaci\u00f3n de la c\u00fapula vesical, se realiza en la inserci\u00f3n del uraco y evita la fijaci\u00f3n de la mucosa vesical a piel, creando una f\u00edstula-v\u00e9sico-cut\u00e1nea.\nLa vesicostom\u00eda-de-bot\u00f3n ha sido eficaz y segura en el 96,4%. Ha facilitado la estabilidad vesical en el 100%, as\u00ed como la realizaci\u00f3n de estudios urodin\u00e1micos est\u00e1ndar-por uretra- durante el evolutivo y como dato objetivo de indicaci\u00f3n de desderivaci\u00f3n-urinaria. Favoreci\u00f3 la realizaci\u00f3n de cateterizaci\u00f3n vesical intermitente, previo al cierre de la vesicostom\u00eda. Destacamos la ausencia de complicaciones. El cierre de la vesicostom\u00eda se realiz\u00f3 a una media de edad de 20 meses, concomitante con la reconstrucci\u00f3n del TUI, cuando fue necesaria.\nLa vesicostom\u00eda-de-bot\u00f3n ha cambiado el pron\u00f3stico evolutivo de la vesicostom\u00eda cl\u00e1sica, siendo resolutiva en la normalizaci\u00f3n de la alta presi\u00f3n del TUI, en ausencia de complicaciones y facilitando la realizaci\u00f3n de estudios urodin\u00e1micos; clave para la desderivaci\u00f3n.",
    "authors": [
        {
            "affiliation": "Secci\u00f3n de Urolog\u00eda Pedi\u00e1trica. Servicio de Cirug\u00eda Pedi\u00e1trica. Hospital Virgen de la Salud. Complejo Hospitalario Universitario de Toledo.",
            "firstname": "R",
            "initials": "R",
            "lastname": "Mart\u00edn-Crespo Izquierdo"
        },
        {
            "affiliation": "Secci\u00f3n de Urolog\u00eda Pedi\u00e1trica. Servicio de Cirug\u00eda Pedi\u00e1trica. Hospital Virgen de la Salud. Complejo Hospitalario Universitario de Toledo.",
            "firstname": "H",
            "initials": "H",
            "lastname": "Ram\u00edrez Velandia"
        },
        {
            "affiliation": "Secci\u00f3n de Urolog\u00eda Pedi\u00e1trica. Servicio de Cirug\u00eda Pedi\u00e1trica. Hospital Virgen de la Salud. Complejo Hospitalario Universitario de Toledo.",
            "firstname": "N",
            "initials": "N",
            "lastname": "Carrera Guermeur"
        },
        {
            "affiliation": "Secci\u00f3n de Urolog\u00eda Pedi\u00e1trica. Servicio de Cirug\u00eda Pedi\u00e1trica. Hospital Virgen de la Salud. Complejo Hospitalario Universitario de Toledo.",
            "firstname": "P",
            "initials": "P",
            "lastname": "Maruszewski"
        },
        {
            "affiliation": "Secci\u00f3n de Urolog\u00eda Pedi\u00e1trica. Servicio de Cirug\u00eda Pedi\u00e1trica. Hospital Virgen de la Salud. Complejo Hospitalario Universitario de Toledo.",
            "firstname": "R",
            "initials": "R",
            "lastname": "Luque Mialdea"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": null,
    "journal": "Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica",
    "keywords": [
        "Button vesicostomy",
        "Clean intermittent catheterization",
        "Decompression of lower urinary tract",
        "Newborn",
        "Surgical technique",
        "Urodynamic studies"
    ],
    "methods": null,
    "publication_date": "2017-12-22",
    "pubmed_id": "29266889",
    "results": "Button vesicostomy was found to be safe and effective in 96%. Stabilization of upper urinary tracts was achieved in all cases. Botton vesicostomy has made it possible to undergo intermittent catheterization through the button before closure of the vesicostomy, as well as performing standard urodynamic studies through the urethra to evaluate bladder function during follow-up and providing objective data for proper undiversion. There were no complications. Vesicostomy was closed at a median age of twenty months, combined with reconstructive procedures, when necessary.",
    "title": "[Button vesicostomy in newborn: an alternative of classical cutaneous vesicostomy].",
    "xml": "<Element 'PubmedArticle' at 0x7885035ec180>"
}