Application of the Yang-Monti channel in adult continent cutaneous urinary diversion.
OBJECTIVE
To report 8 cases using the Yang-Monti channel with ileum for adult continent cutaneous urinary diversion.


METHODS
From 2004 to 2006, 108 patients underwent urinary diversion, 8 of whom had a continent cutaneous reservoir using the Yang-Monti principle. Channels were created by transversely retubularizing 2 to 3 cm of ileum. Indications, technique, complications, and outcomes, such as continence and ease of channel catheterization, are reported.


RESULTS
Five patients underwent a right colon reservoir urinary reconstruction after extirpative surgery. Orthotopic neobladders were not performed, owing to anatomic or oncologic concerns. Two additional patients underwent an augmentation, with 1 undergoing an Indiana pouch revision. All urinary reservoirs but 1 were connected to the umbilicus. Two strictures occurred, which were treated with in-office dilation. Incontinence was identified in 2 patients and successfully treated with dextran microspheres injections. All patients were continent at final follow-up. Seven patients continue to perform intermittent catheterization, and 1 patient is managed with an indwelling catheter, owing to comorbidities.


CONCLUSIONS
The Yang-Monti channel using ileum is an alternative as a neo-appendicoumbilicostomy in construction of continent cutaneous urinary diversion. The channel is surgically versatile and can be used in the creation of a right colon pouch when the appendix is unavailable.
Wagner
Matthew
M
Section of Urologic Oncology, Division of Urology and Renal Transplantation, Oregon Health & Sciences University, Portland, Oregon 97239, USA.
Bayne
Aaron
A
Daneshmand
Siamak
S
D000328:Adult; D000368:Aged; D062109:Dermatologic Surgical Procedures; D006801:Humans; D007082:Ileum / Q000601:surgery; D008875:Middle Aged; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent