Bowel-flap tubes for continent cutaneous urinary diversion.
The appendix stoma for Mainz-pouch continent cutaneous urinary diversion is reliable and easy to perform. Two new continence mechanisms were developed for patients in whom the appendix is not available or usable. A seromuscular tube was used in 27 patients (12 women, 15 men, mean age 63 years) and a bowel-wall tube was used in 24 patients (13 women, 11 men, mean age 57 years) as the continence mechanism for continent cutaneous urinary diversion. At a mean follow-up of 32 months (range 2-68 months), 93% of patients with a seromuscular tube and 92% of those with a bowel-wall tube are continent day and night. Four early and nine late stoma-specific complications have occurred, requiring seven open surgical revisions. Thus far, both techniques have fulfilled all requirements as continence mechanisms for continent cutaneous urinary diversion. However, the reliability, advantages, and disadvantages of these techniques have to be confirmed in further long-term studies.
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Department of Adult and Pediatric Urology, Klinikum Wuppertal, University of Witten/Herdecke, Medical School, Germany.
Thüroff
J W
JW
D002432:Cecum / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D013524:Surgical Flaps; D013536:Suture Techniques; D013997:Time Factors; D001745:Urinary Bladder Diseases / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods; D016476:Urinary Reservoirs, Continent