Radionuclide evaluation of the uretero-ileoceco-proctostomy (ileocecal rectal bladder)

Technetium 99m diethylenetriaminepentaacetic acid renoscintigraphy was applied to 14 patients to obtain comprehensive information on the kidney and urinary tract 12.6 +/- 8.8 months (mean +/- SD) after uretero-ileoceco-proctostomy (ileocecal rectal bladder) diversion. The total glomerular filtration rate (GFR) was within the normal range in all patients, and the diuretic renogram was normal in 19 of 28 kidneys, dilated-nonobstructive in 7 and obstructive-intermediate in 2. The mean colonic reflux was 16.6 +/- 18.4% of total excretion and the mean total residual in the colon and rectum was 38.8 +/- 15.5%. In the second study, performed 12.4 +/- 3.5 months later in 9 patients, the GFR of bilateral and individual kidneys remained stable, 17 of 18 kidneys were normal as judged by both renography and pyelography, and the occurrence and degree of colonic reflux decreased. There was a tendency for the rectal capacity to increase, while the total residual tended to decrease solely due to the decrease in colonic residual. These results indicate that the ileocecal rectal bladder functions well as an internal continent reservoir and that radionuclide investigation is a valuable and cost-beneficial means of follow-up of urinary diversions.