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Continence mechanism based on a modified ileocecal valve.
1Department of Urology, UCLA School of Medicine, Los Angeles, California, USA.
Techniques in Urology
|August 30, 2000
Summary
A continent urinary diversion using the ileocecal valve offers a simple, reliable solution for urinary continence. This technique achieved an 83% success rate in patients requiring lower urinary tract reconstruction.
Area of Science:
- Urology
- Surgical Innovation
- Continent Urinary Diversion
Background:
- Lower urinary tract reconstruction is necessary for various conditions including malignancy, neurogenic bladder, and urethral dysfunction.
- Continent urinary diversion aims to provide reliable urinary continence and improve quality of life.
- The ileocecal valve presents a potential natural mechanism for achieving urinary continence.
Purpose of the Study:
- To describe a simple technique for creating a continent urinary diversion using the ileocecal valve.
- To evaluate the efficacy and safety of this ileocecal valve-based continence mechanism.
Main Methods:
- A continent stoma was constructed using the ileocecal valve in 28 patients over 3 years.
- The technique involved tapering the ileal segment and securing it to the cecum for enhanced continence.
- Twenty-three patients were available for follow-up evaluation.
Main Results:
- Continence was achieved in 83% (19 of 23) of evaluated patients.
- Two patients required revision for persistent incontinence and are now dry.
- No complications such as difficult catheterization or peristomal hernia were reported; one case of stomal stenosis was successfully treated.
Conclusions:
- The described technique provides a simple, reliable method for constructing a continent cutaneous urinary reservoir.
- This approach offers a low-morbidity solution for patients needing urinary diversion.
- The ileocecal valve serves as an effective natural continence mechanism in this surgical technique.
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