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A new continent vesicostomy technique: preliminary report
1Department of Urology, Hillel Yaffe Medical Center, Hadera, and Sackler Medical School, University of Tel-Aviv, Israel.
The Journal of Urology
|May 1, 1997
Summary
This study presents a novel continent vesicostomy technique using only bladder wall and rectus muscle. This method creates a continent, esthetically pleasing stoma without requiring tissue from other organs, achieving excellent dryness.
Area of Science:
- Urology
- Surgical Innovation
- Reconstructive Surgery
Background:
- Continent urinary diversions are essential for managing bladder dysfunction.
- Existing techniques often involve complex reconstructions or segments from other organs.
- A need exists for simpler, more esthetic continent stoma options.
Purpose of the Study:
- To describe a novel technique for continent vesicostomy construction.
- To evaluate the efficacy and esthetics of this new surgical approach.
- To demonstrate a method that avoids using tissue from non-urinary organs.
Main Methods:
- A continent vesicostomy was created using a tubularized bladder wall flap as a neourethra.
- Rectus muscle strands were utilized to enhance the closure pressure of the neourethra.
- The stoma was positioned either at the pubic hairline or below the umbilicus.
Main Results:
- The technique was applied to 7 patients (4 female, 3 male).
- Mean follow-up was 28 months (range 3-42 months).
- All patients achieved complete dryness between self-catheterizations, day and night.
Conclusions:
- This continent vesicostomy technique provides reliable urinary continence.
- The method results in an esthetically acceptable and easily accessible stoma.
- It successfully avoids the use of grafts from other organs, simplifying the procedure.