Conversion of an incontinent urinary conduit to a continent urinary reservoir (Miami Pouch).
OBJECTIVE
External urinary or gastrointestinal appliances can impair a patient's quality of life. We report on the feasibility of converting an incontinent colonic urinary diversion to a continent urinary reservoir (Miami Pouch).


METHODS
We describe the case of a 66-year-old white female with a history of stage Ib(2) cervical cancer treated by radical abdominal hysterectomy and adjuvant radiation therapy. The patient developed severe radiation cystitis with a neurogenic bladder and bilateral ureteral obstruction. After failing conservative management, a urinary diversion with a transverse colon conduit was performed. The patient remained without evidence of disease for 2 years and led an active lifestyle with regular tennis games. After 7 months of an external appliance for the urinary conduit, the patient presented to the University of Miami for conversion to a continent urinary mechanism which would not require an appliance. We performed an exploratory laparotomy, conversion of a transverse colon conduit to a continent ileo-colonic urinary reservoir (Miami Pouch). There were no postoperative complications. The patient remains disease-free and performs self-catheterization with no need for an external appliance. The patient has been able to resume an active life including sports.


CONCLUSIONS
Successful conversion of an incontinent urinary conduit to a continent urinary reservoir is possible in a select case resulting in a perceived improvement of quality of life.
Benezra
Victor
V
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Jackson Memorial Hospital, University of Miami, Miami, FL 33136-1096, USA. drbenezra@aol.com
Lambrou
Nicholas C
NC
Salom
Emery M
EM
Penalver
Manuel A
MA
D000368:Aged; D003556:Cystitis / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D011832:Radiation Injuries / Q000209:etiology / Q000601:surgery; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000209:etiology; D016476:Urinary Reservoirs, Continent; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy / Q000601:surgery