The MIC‐KEY button vesicostomy: a superior alternative for suprapubic drainage?

Objectives To evaluate the MIC‐KEY button vesicostomy as an alternative to indwelling suprapubic catheters (SPCs) for bladder drainage in adults. Patients and Methods Phase II pilot study prospectively evaluating patients with indwelling SPCs that were converted to MIC‐KEY buttons, or cystoscopic‐guided de novo insertion, between November 2014 and February 2019. In all, 15 patients (14 female, one male) had indwelling SPCs that had conversion or attempted conversion to MIC‐KEY button, and one (male) had a cystoscopic‐guided de novo insertion with a history of previous suprapubic catheterisation. The mean (range) age was 44.2 (13–73) years. Catheter‐related quality‐of‐life (C‐IQoL) questionnaire data were collected at baseline and 3 months. Results Two patients had attempted conversion but were abandoned perioperatively due to sizing issues and insertion difficulties, respectively. Three patients were subsequently converted back to a SPC; due to button sizing (18 days), leaking (3 months), and recurrent infection (13 months). The remaining 11 patients have remained well with continued drainage via the MIC‐KEY button; mean (range) duration since conversion was 34.2 (5–105) months. The C‐IQoL score improved 3 months after insertion, from 50.0 to 75.4. Changes were performed dependent on patient's personalised management, typically every 3 months, under local or general anaesthetic. Conclusion The MIC‐KEY button is a safe alternative to SPC drainage in adults in the short‐ to medium‐term, in a selected cohort.