[Experimental and clinical results with the ileum pouch as a continence-preserving replacement bladder]

Clinical use of the ileum-pouch for bladder reconstruction without stoma and direct anastomosis to the urethra is mandatorily based upon the three following conditions: sufficient capacity, low pressure values and protection of reflux in the neobladder. In an experimental study, we constructed a U-pouch with anastomosis to the urethra and implantation of both ureters into a cranial ileum horn. Already six weeks postoperatively an optimal capacity and real low pressure conditions of the neobladder have been achieved. Without any ileoileal invagination as antirefluxive procedure simple ureter-nippling provides a highly efficient protection against renal reflux in the so constructed neobladder. Our first clinical results do confirm our experimental data, demonstrating no reflux and almost total continence.