T-mechanism applied to urinary diversion: the orthotopic T-pouch ileal neobladder and cutaneous double-T-pouch ileal reservoir.
OBJECTIVE
As the evolution of lower urinary tract reconstruction continues, newer and improved forms of urinary diversion have developed. Critical components of continent urinary reservoirs included an antireflux and continent mechanism that is effective, durable, easily constructed, and associated with little morbidity.


METHODS
We describe the flap valve known as the T-mechanism as it applies to an afferent antireflux mechanism in an orthotopic ileal reservoir (T-pouch) and as an antireflux and efferent continence mechanism in the continent cutaneous ileal reservoir (double T-pouch).


CONCLUSIONS
We believe the T-mechanism is an extremely effective and versatile flap-valve technique that can be easily learned and applied to the construction of continent urinary diversions.
Stein
J P
JP
Department of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles 90089, USA.
Skinner
D G
DG
D006801:Humans; D007082:Ileum / Q000601:surgery*; D016737:Proctocolectomy, Restorative / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D001743:Urinary Bladder / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*