[Bladder replacement by a continent ileocolonic intestinal reservoir wih antireflux-plasty--experimental study in the...

The purpose of this experimental study was to try to develop a continent appliance-free urinary diversion with a non-refluxing urinary reservoir to be emptied by intermittent catheterization. A reliable antireflux plasty can be performed only on the large bowel wall. Continence can only be achieved using small bowel. For these reasons an ileo-colic urinary reservoir was conceived and experienced in 20 beagle dogs of both sexes. The posterior wall of the reservoir is formed by an intestinal plate constructed with two ileal loops. Continence is achieved by intussuscepting the terminal ileum in a retrograde fashion into the reservoir for a distance of 5 cm, thus creating a competent nipple valve between the pouch and the ileostoma. The anterior wall of the reservoir is formed using a colonic plate obtained by dividing the excluded sigmoid colon at the antimesenteric border. A long submucuous tunnel is created in the colon in which to lay the ureter. Thus renal infection and chronic pyelonephritis are avoided. Continence of the stoma is both socially and economically acceptable and improves the quality of life.