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Continent reservoirs.

J W Colberg, S F Schiff, B Lytton

    Connecticut Medicine
    |October 1, 1989
    PubMed
    Summary
    This summary is machine-generated.

    Continent urinary diversion using detubularized intestinal reservoirs offers a safe and effective solution for patients post-cystectomy. This major advance provides reliable urinary continence, significantly improving patient quality of life.

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    Area of Science:

    • Urology
    • Surgical Oncology
    • Gastroenterology

    Background:

    • Cystectomy, the surgical removal of the bladder, necessitates urinary diversion for affected patients.
    • Continent urinary diversion represents a significant advancement over traditional methods, aiming to restore normal urinary function and improve quality of life.

    Purpose of the Study:

    • To evaluate the safety and efficacy of continent urinary diversion in patients who have undergone cystectomy.
    • To assess the outcomes of two types of continent urinary diversion: those with a continent stoma and those with urethral anastomosis.

    Main Methods:

    • A retrospective review of 28 patients who underwent continent urinary diversion at Yale New Haven Hospital over three years.
    • Categorization of patients into two groups: those with a continent reservoir and abdominal stoma (n=13) and those with a urethral anastomosis (n=15).

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  • Inclusion of urodynamic studies to assess bladder function and continence.

    • Main Results:

    • All 28 patients achieved daytime urinary continence.
    • Over 50% of patients experienced nighttime continence, with a recent modification showing promise in resolving nocturnal incontinence.
    • The majority of patients with urethral anastomosis voided spontaneously.

    Conclusions:

    • Detubularized intestinal reservoirs are a safe and effective method for achieving continent urinary diversion in selected patients post-cystectomy.
    • Continent urinary diversion significantly improves urinary control and quality of life for patients following bladder removal.
    • Ongoing modifications to reservoir construction may further enhance outcomes, particularly regarding nocturnal continence.