Simple flap valve for continent urinary diversion.
OBJECTIVE
To provide a stable continence mechanism in patients with urinary diversion by creating a flap valve from the ileal wedge, sutured into the grooves of the reservoir mucosa.


METHODS
The valve's efficacy and stability were confirmed previously in an experimental study using five dogs. The valve was used in 22 patients with ileocaecal pouches and as a continence mechanism for cystostomy in two paraplegic women.


RESULTS
Continence was achieved in all but two patients. In these exceptions the valve was found to be abnormally short (only 2 cm). Re-operation restored one patient to continence but the second patient refused further surgery. There were no problems with either catheterization of the valve or with epithelialization of the serosal surface of the valve.


CONCLUSIONS
The valve is easy to construct and requires only a small intestinal segment; it has long-term mechanical and functional stability and can be easily catheterized. The valve provides continence even with increasing reservoir content and will accept a large catheter, which seems to be important in preventing lithiasis.
Department of Urology, St Anne's Faculty Hospital, Brno, Czech Republic.
J P
JP
Mráz
M
M
Sutory
P
P
Zerhau
D000293:Adolescent; D000328:Adult; D000368:Aged; D002432:Cecum / Q000637:transplantation; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D016476:Urinary Reservoirs, Continent / Q000379:methods*