Hemi-T pouch modification for pediatric urinary diversion.
OBJECTIVE
When the appendix is unavailable, there are limited reliable methods for continent urinary diversion. After successful application of double-T pouch urinary diversion in adults we modified the technique for bladder augmentation and continent diversion.


METHODS
A 10-year-old male underwent bladder augmentation and continent urinary diversion with a hemi-T augment. Modifications of the T pouch technique are described in detail. We also reviewed the literature on tapered ileal diversions, such as the Yang-Monti procedure.


RESULTS
One year after surgery the patient was continent. He was free of infection and bilateral hydronephrosis resolved. Urodynamics demonstrated a continent 350 ml reservoir without reflux.


CONCLUSIONS
For patients who require concomitant bladder augmentation and continent diversion a hemi-T augment is a suitable option when the appendix is unavailable. It is especially true when there is minimal bladder available for implantation of a Yang-Monti conduit.
Kurzrock
Eric  A
E
Department of Urology and Pediatrics, University of California-Davis Children's Hospital and School of Medicine, 4860 Y Street, Suite 3500, Sacramento, CA 95817, USA.
Skinner
Donald G
DG
Stein
John P
JP
D002648:Child; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000601:surgery*