"Clam" ileocystoplasty for the treatment of refractory urge incontinence

Forty patients with refractory urge incontinence were treated by "clam" ileocystoplasty. Thirty patients were cured of their symptoms and are voiding spontaneously, six were cured of their symptoms and are on clean intermittent self-catheterisation and four had their symptoms significantly improved by the operation. Bladder compliance is usually improved by the operation and detrusor instability is either abolished or reduced to an insignificant level, but voiding dysfunction is a common post-operative problem and must be identified and treated.