[Urodynamics of the continent neovesical]

The authors present an account of urodynamic findings in 14 patients after replacement of the urinary bladder by a detubulized ileocoecal or ileal segment sutured in the shape of a pouch. An ileocoecal pouch (so-called Mainz pouch) was anastomized in nine patients to the urethra and in three it was led into the umbilicus by an ileal valve. Through this valve the patients are intermittently catheterized. In two patients an ileal neovesica stitched to the urethra was created. After a 1-12-months interval following operation the authors evaluate the urinary flow (average 12 ml/s), the residue after micturition (0-170 ml), the intravesical pressure at rest (mean 17 cm H2O), the compliance of the neovesica (mean 47 ml/cm H2O), the urethral closing pressure (mean 51 cm H2O) and continence. This type of replacement meets the demands of a large-volume, low-pressure reservoir, it has also a satisfactory evacuating ability and ensures satisfactory continence.