Double folded rectosigmoid bladder with a new ureterocolic antireflux technique.

Abstract

PURPOSE:

We present a new method of urinary diversion to the rectum.

MATERIALS AND METHODS:

Between 1992 and 1995 a new surgical procedure was used in 32 women, 20 men and 12 children 3 to 60 years old (mean age plus or minus standard deviation 35.4 +/- 2.2). The main indication for diversion was invasive bladder carcinoma. Surgery entailed creation of an S-shaped double folded rectosigmoid reservoir with implantation of the ureters via an extramural serous lined antireflux technique.

RESULTS:

One patient died of a massive pulmonary embolism postoperatively. Followup ranged from 6 to 36 months (mean 19.2 +/- 7.0). During the observation period 6 patients died of local recurrence and/or distant metastasis within 8 months. Of the patients 57 are currently evaluable. All patients are continent during the day with an emptying frequency of 2 to 4 times. Nocturnal enuresis was observed in 4 children who responded favorably to imipramine hydrochloride therapy. Upper urinary tract function was maintained or improved in 95% of the patients. No clinical evidence of acidosis was observed, since all patients were kept on prophylactic oral alkalization.

CONCLUSIONS:

The procedure can circumvent some of the inherent disadvantages of ureterosigmoidostomy and is a good alternative to orthotopic bladder substitution when the urethra cannot be used.

• Authors: M M el Mekresh, A T Hafez, H Abol-Enein, M A Ghoneim
• Journal: The Journal of urology (J Urol) Vol. 157 Issue 6 Pg. 2085-9 (Jun 1997) ISSN: 0022-5347 [Print] United States
• PMID: 9146586 (Publication Type: Clinical Trial, Journal Article)

Topics

• Adolescent
• Adult
• Child
• Child, Preschool
• Colon (surgery)
• Colon, Sigmoid (surgery)
• Female
• Follow-Up Studies
• Humans
• Infant
• Male
• Middle Aged
• Rectum (surgery)
• Ureter (surgery)
• Urinary Bladder Neoplasms (surgery)
• Urinary Reservoirs, Continent (methods)