Bladder replacement with sigmoid colon after radical cystoprostatectomy

Sigmoid colon was used to replace the bladder after radical cystoprostatectomy in 10 patients with bladder cancer. A U- or J-shaped segment of the sigmoid colon was anastomosed at the most dependent portion to the urethral stump. The ureters were implanted in each end of the loop via an antireflux tunneling technique. There was no operative mortality, and the complications associated with this form of bladder replacement were minimal. All 10 patients had sensations of filling, and 8 of 10 achieved full daytime continence with complete voluntary emptying. Enuresis was present in all patients and required condom catheters during sleep, which were well tolerated. We believe that a tubular sigmoid segment is an acceptable alternative to tubular ileum or cecum for total bladder replacement.