Transverse colon for continent urinary diversion: experimental study comparing two techniques

Patients who have undergone pelvic radiotherapy can develop urinary complications such as actinic cystitis or fistulas and ultimately need urinary diversion, for which several techniques have been described. The purpose of this experimental study was to compare 2 different types of continent urinary diversion with the colonic pouch.

Sixteen dogs of both sexes, weighing 20-25 kg were divided into 3 groups: the pilot group consisted of 6 dogs used to standardize the technique. Group 1 consisted of 5 dogs that underwent the Monti technique to construct the conduit and the Abol-Eneim technique to promote continence. The final group, group 2, consisted of 5 dogs that underwent the intussusception technique for continence. In both techniques the same length of colon was used (20 cm). Urodynamic evaluation was performed at postoperative day 30.

The compliance of the reservoir was similar among the groups. The capacity of the reservoir was greater and the continence mechanism was more effective in group 1. The length of the conduit was also longer in group 1. In group 2, the intussusception's mechanism was totally lost in 1 dog and partially in 2.

The technique performed in group 1 allowed for the construction of a reservoir with greater capacity and the continence mechanism proved to be more efficient than in group 2. The length of the conduit was significantly greater in group 1.