Problems with storing urine and emptying the bladder can arise in children with particular health conditions. If not managed promptly, children may develop urinary tract infections and damage to the upper urinary tract, including chronic kidney disease. Management options for urine storage and bladder emptying problems vary, depending on factors such as the severity of the condition, patient or caregiver’s preferences and whether an option is feasible and safe due to an individual patient’s anatomy.

The use of a vesicostomy button was proposed over 20 years ago, as early as 1996 as an alternative surgical management strategy for some children with urine storage and bladder emptying problems. A vesicostomy is a surgically-created opening (known as a stoma) in the bladder. The vesicostomy button consists of a silicone device which uses a retained feeding tube (a soft tube usually placed in the stomach to allow for feeding), known as a gastrostomy button. The tube component of the vesicostomy button is placed into the vesicostomy to allow intermittent emptying of the bladder, without the need for a traditional catheter and catheter bag.

Following a request from the Minister for Health, HIQA agreed to undertake a rapid Health Technology Assessment (HTA) of the use of vesicostomy buttons in children. The report is now provided as advice to the Minister for Health.