[Bladder substitute realized by means of an ileal segment]

An internal urinary diversion after radical cystoprostatectomy has been performed in 24 male patients. The bladder substitute was made from an ileal segment, opened along its antimesenteric border and folded twice, according to Goodwin's "cup-patch technique". After an observation time of 3 months to 3 years, the results are in general good: no signs of pyelonephritis or metabolic changes, necessitating a substitution, have been observed. The increase of the bladder substitute's capacity is parallel to the improvement of urinary continence. In general, the latter is achieved after 1-3 months during the day, and after 2-6 months during the right. According to our experience, preservation of the neurovascular bundles responsible for erection, helps to regain continence. However, loss of several drops of urine may occur, reason why half of our patients wear a safety pad later than 6 months after surgery, at least during the night.