[Colonic conduit: an alternative to the treatment of urinary incontinence]

We report on 9 patients where on a colon conduit has been constructed. Seven of them suffered from a bladder etrophy, one had a sacral teratoma and the remaining one a vesical rhabdomyoma. The latter two had undergone total cystectomy. This technique involves creation of a conduit with isolation of 10-15 cm of a loop of sigmoid colon. One of its ends is sutured and both ureters become reimplanted with an antireflux procedure. The other end is exteriorized through the skin. Thereafter, once any reflux or uretero-colonic stenosis has been ruled out, the cutaneous stoma is detached and anastomose to the sigmoid colon. Complete technique has been used on six patients. Three of them were operated on two stages with no complications. One patient received one uretero-ureteral anastomosis. Another one had an antireflux technique together with anastomosis between the colon conduit and the sigmoid colon in a one-stage procedure. This same patient had a continent reservoir created with a portion of stomach and the colon conduit. In three cases only the first stage of this operation has been performed and the skin stoma has not been closed because of persisting faecal incontinence. Currently 6 patients are continent (2 of them remain with occasional nocturnal incontinence). The remainder have still an open stoma. Renal function and acid-base balance are normal in all of these patients. Three of them are on bicarbonate support therapy.