Total reconstruction of the lower urinary tract using bowel and the artificial urinary sphincter

We report 3 cases in which the lower urinary tract was reconstructed using bowel. In each instance the cuff was placed around the bowel to provide a continence mechanism. The 2 patients in whom the sigmoid colon was used have sporadic diurnal incontinence with nocturnal enuresis. Urodynamic evaluation has shown that this is secondary to high pressures generated within the closed sigmoid loop. The ileocecocolonic segment is preferable for reconstruction of the lower urinary tract, since the pressure developed within the bowel is significantly lower. The use of the artificial urinary sphincter around the bowel extended the versatility of the device.