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Double folded rectosigmoid bladder with a new ureterocolic antireflux technique
M M el Mekresh1, A T Hafez, H Abol-Enein
1Department of Urology, Mansoura University, Egypt.
The Journal of Urology
|June 1, 1997
Summary
This study introduces a novel rectal urinary diversion technique, showing high daytime continence and preserved upper urinary tract function in 57 patients. It offers a viable alternative for bladder substitution when the urethra is unusable.
Area of Science:
- Urology
- Surgical Innovation
Background:
- Urinary diversion is crucial for managing conditions like invasive bladder carcinoma.
- Traditional methods like ureterosigmoidostomy have inherent disadvantages.
- Orthotopic bladder substitution is not always feasible due to urethral limitations.
Purpose of the Study:
- To present a new surgical method for urinary diversion to the rectum.
- To evaluate the efficacy and safety of this novel rectosigmoid reservoir technique.
Main Methods:
- A new surgical procedure involving an S-shaped, double-folded rectosigmoid reservoir was performed on 64 patients (32 women, 20 men, 12 children).
- Ureters were implanted using an extramural, serous-lined antireflux technique.
- Patients were monitored for continence, urinary tract function, and metabolic complications.
Main Results:
- 57 patients were evaluable postoperatively, with follow-up ranging from 6 to 36 months.
- All evaluable patients achieved daytime urinary continence, with 2-4 emptying episodes daily.
- Upper urinary tract function was maintained or improved in 95% of patients; no clinical acidosis was observed with prophylactic alkalization.
Conclusions:
- This rectosigmoid reservoir procedure offers a safe and effective alternative for urinary diversion.
- It successfully circumvents disadvantages associated with ureterosigmoidostomy.
- It serves as a valuable option for bladder substitution when urethral preservation is not possible.