Continent reservoirs

Continent urinary diversion is a major advance in the treatment of selected patients following cystectomy. Twenty-eight patients have undergone some form of continent urinary diversion at Yale New Haven Hospital during the past three years; thirteen have a continent reservoir with a continent stoma on the abdominal wall, and empty the urine by self-intermittent catheterization, and 15 have a reservoir anastomosed to the urethra, the majority of whom void spontaneously. All are continent by day and over 50% are continent at night. A recent modification in the construction of the urinary reservoir would appear to have resolved the problem of nocturnal incontinence. The results and urodynamic studies in this group of patients are discussed, and it is concluded that a detubularized intestinal reservoir provides a safe and effective method for continent urinary diversion in selected patients following cystectomy.