Modified urethro-ileal anastomosis in the Studer ileal bladder

Studer ileal bladder substitute is a low pressure reservoir anastomosed to the membranous urethra. Suitable length of mesentery is necessary to allow the ileal loop to reach the urethral stump. However, reconfiguration by double folding of the detubularized ileal segment tends to move the inferior portion of the pouch away from the membranous urethra making more difficult, if not impossible, the ileo-urethral anastomosis. In order to avoid this technical limitation, we suggest a reconfiguration of the lowest portion of the pouch into the shape of a 5-cm-long funnel, which permits the loop to approach the urethral stump and therefore facilitates the ileo-urethral anastomosis. This technique has been successfully employed in 10 patients. Eight of them have clinical, radiological and urodynamic follow-up.