Prosthetic Access Device Use of a Gastrostomy Button for the Bladder

An alternative to formation of a continent catheterizable subcutaneous channel is placement of a prosthetic device on the lower abdominal wall that allows CIC such as a gas-trostomy button (CR Bard, Covington, GA). Bennett et al.11 in 2003 described the outcomes of using such a device in 20 cases of evacuation disorders of the bladder that is placed through a matured suprapubic tube tract. Similar to catheter intubations for gastric feeding, this device serves as a continent abdominal portal for patients to perform CIC. Although symptomatic infections and encrustations of the portal device were low, the failure rate in this series was attributed to technical issues of skin erosions surrounding the device that were caused by the short length of the prosthetic in relationship to abdominal wall thickness for 60% of patients. Patients with less than 4 cm of abdominal wall thickness do well with this device, and development of a device specifically for the bladder (i.e., variation in device length) will expand the use and adoption of this minimally invasive technique.

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