Bellevue pouch: ileocolonic continent urinary reservoir

Area of Science:

• Gastroenterology
• Surgical Techniques
• Urology

Background:

• Continent urinary diversions are essential for managing bladder exstrophy and other conditions.
• Existing continent diversion techniques have varying success rates and complexities.
• The Bellevue Pouch offers an alternative continent intestinal reservoir construction.

Purpose of the Study:

• To describe the surgical technique for creating the Bellevue Pouch.
• To evaluate the efficacy and safety of the Bellevue Pouch in achieving urinary continence.

Main Methods:

• The Bellevue Pouch is constructed from detubularized ascending colon, cecum, and terminal ileum.
• A large-capacity, low-pressure reservoir is formed.
• Continence is achieved via an intussuscepted ileal segment and a colonic pressure cuff.

Main Results:

• The procedure was performed on 19 patients.
• All 19 patients achieved satisfactory continence.
• Two patients were later converted to free drainage systems.
• Average follow-up was 25 months.

Conclusions:

• The Bellevue Pouch technique provides a reliable method for creating a continent intestinal reservoir.
• Satisfactory continence was achieved in all patients undergoing this procedure.
• Further evaluation may be warranted for patients requiring conversion to free drainage.