The ileocecal bladder: a new method for urinary diversion after radical cystectomy (a preliminary report)

Ten patients underwent radical cystectomy and ileocecal bladder reconstruction for carcinoma of the bladder. The ileocecal region was used as an artificial bladder, its valve protecting the kidneys from back pressure exerted by the external urethral sphincter. The ureters were anastomosed to the ileal part and the cecum was anastomosed to the prostatic urethra in 7 men and to the bladder neck in 2 women and 1 man. Two patients died postoperatively. All patients had perfect control of micturition during the day. Those in whom the bladder neck was preserved were also fully continent at night. The remaining patients had a minor degree of nocturnal enuresis with only a few drops of urine voided involuntarily during sleep. All patients feel the desire to void when the bladder is full. Voiding cystograms in all patients did not reveal reflux in the ureters. IVP's done up to 11 months postoperatively showed preservation and improvement of kidney function and configuration. Followup cystometric studies and serum electrolyte determinations are under investigation.