Use of the umbilical area for placement of a urinary stoma.

Children with myelodysplasia are best managed in medical centers by a team consisting of a urologist, an orthopedist, a neurosurgeon, a pediatrician, a social worker, an orthotic technician and physical therapists. A co-operative approach aids in the selection of a urinary diversion stoma site which will not interfere with the multiple orthopedic procedures these children must undergo. The urologic and orthopedic complications and benefits of 24 patients with umbilical stoma are compared with 24 patients with matched right lower quadrant stoma. The incidence of urologic complications is equal, while the orthopedic advantages manifest by the first group vastly outweigh the problems encountered in the second group. We advocate the use of a midline stoma site for urinary diversion in children with myelodysplasia.