Long-term outcomes of Blocksom vesicostomy for elderly patients with chronic urinary retention

Purpose To report on the long-term outcomes of vesicostomy in elderly patients with chronic urinary retention. Materials and methods We conducted a study of 16 elderly patients with chronic urinary retention who underwent Blocksom vesicostomy between April 2010 and March 2021. Postoperative follow-up was conducted every 3 months to check for abnormal findings, such as stoma outlet obstruction, infection, bleeding, bladder prolapse, and bladder stones. The incidence of these findings and the time until they occurred, as well as the rate of achieving a catheter-free status and the time until catheter reinsertion, were then calculated using the Kaplan-Meier curve. Results The mean age (+/- standard deviation) of patients whose cases were observed was 78.6 (+/- 7.8) years; the oldest patient was 87 years of age. The study population included 14 male patients and 2 female patients, with a higher number of males. The causes of urinary retention included neurogenic bladder in 12 patients (including patients with 3 spinal cord injury), advanced prostate cancer in 2 patients, and iatrogenic urethral stricture in 2 patients. The average follow-up period was 55.7 months. During follow-up, 14 patients (87.5% of the total) achieved a catheter-free status under conditions that required no additional treatment. Complications were observed in 6 cases (37.5%); among them, two cases required reoperation. All complications were observed within 2 years after surgery. Conclusion Blocksom vesicostomy may become a viable option in the treatment of elderly patients with chronic urinary retention whose symptoms do not improve with medical therapy.