Bladder neck closure with an Indiana stoma outlet as a technique for continent vesicostomy

A continent vesicostomy was performed upon two patients. The opened right colonic segment was used to augment the bladder and the ileocecal portion to create a continent abdominal stoma according to the technique used in the Indiana pouch. One patient had complete obstruction of the urethra 1 centimeter distal to bladder neck. The second patient was a paraplegic with an contractile bladder and complete outlet incontinence who was reluctant to perform transurethral self-catheterization. After postoperative follow-up evaluation of 36 and 22 months, respectively, both patients are completely continent day and night on self-catheterization every six hours with preserved function of the upper part of the tract.