Ileocecal conduit for temporary and permanent urinary diversion.
The ileocecal intestinal segment has been used as a diverting conduit with a satisfactory colonic stoma in 6 patients with potentially reversible bladder disorders. Followup has been from 1 to 5 years. The ileocecal valve has been modified successfully by a fundoplication procedure similar to the Nissen esophagogastric junction operation to prevent ileocecal and ureteral reflux. IVP and renal function studies revealed resolution of pre-existing hydronephrosis and preservation of previously normal upper urinary tracts. One patient has undergone reversal of the diversion by cecocystoplasty and simultaneous bladder augmentation, and has been followed for 5 years with sterile urine and normal IVPs. The anatomic and functional advantages of a conduit with an antireflux mechanism that is applicable to the hydronephrotic collecting system are discussed.
D000293:Adolescent; D000328:Adult; D002432:Cecum / Q000601:surgery*; D002648:Child; D003125:Colostomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery; D007082:Ileum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care; D013536:Suture Techniques; D013997:Time Factors; D014547:Urinary Diversion / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000517:prevention & control