[Enlargement colocystoplasty with temporary skin opening. Modification of the trans-appendicular continent cystostomy technic]

The results of trans-appendix continent vesicostomy, described in 1980 by P. Mitrofanoff, depends on the capacity of the neurogenic bladder. A cystoplasty using the sigmoïd colon is able to resolve the problem of small and hypertonic bladders. The colon conduit is placed between the bladder and the antero-lateral wall of the abdomen, where a temporary urinary stoma is performed. Results of this technic are reported in 3 cases: no specific complication related to the colocystoplasty has been observed. In all cases, the colon conduit permits a large capacity. It reduces the intravesical pressure and the risk of urinary fistula and urethral repermeation. If any accident occurs, it is easy to re-open the sigmoïdal stoma and to obtain an efficient decompression of the urinary tract. With this technic, it is possible to perform a continent vesicostomy in most children with neurogenic bladder.