title: Fascial sling correction of kinked efferent limb in patients with continent diversion and catheterization difficulty.
abstract: OBJECTIVE
  We determined the efficacy of using a rectus fascial sling to revise an angulated efferent limb in patients with continent urinary diversion and difficulty with intermittent catheterization.
  
  
  METHODS
  Two spinal cord injured women who underwent modified Indiana pouch urinary diversion required revision of each efferent limb because of difficulty with catheterization. A strip section of anterior rectus sheath was harvested and used to fix the efferent limb in position, assuring freedom from angulation and facilitating catheterization.
  
  
  RESULTS
  Both patients remained continent for more than 2 years postoperatively and neither had further difficulties with catheterization or required additional surgery.
  
  
  CONCLUSIONS
  Use of the rectus fascial sling in continent urinary diversion enables fixation of the efferent limb to facilitate catheterization and enhance continence.
authors.affiliation: Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Chancellor
authors.forename: P J
authors.initials: PJ
authors.lastname: Shenot
authors.forename: R D
authors.initials: RD
authors.lastname: Hong
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: D A
authors.initials: DA
authors.lastname: Rivas
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D014546:Urinary Catheterization; D016476:Urinary Reservoirs, Continent