Continent cutaneous diversion.
Continent urinary diversion requires the creation of a reservoir, ureteric implantation and establishment of a continence mechanism in the efferent segment. This review is a short overview on the history of different techniques in current use. Reservoirs with high volume and low pressure can be fashioned by antimesenteric opening and spherical reconfiguration of the bowel. Previously, techniques for ureteric implantation were simply transferred to continent urinary diversion. Currently the need for antirefluxive ureteric implantation techniques is questioned and there is a trend towards refluxive implantation. To create a continence mechanism, simple and reproducible procedures. e.g. the incorporation of the efferent segment into the pouch wall (e.g. appendix stoma, flap valve T mechanism, serosal-lined extramural tunnel) have been developed. Long-term data for different surgical techniques show excellent continence and acceptable complication rates.
Fisch
Margit
M
Center of Urology and Paediatric Urology, Asklepios Klinik Harburg, Hamburg, Germany. m.fisch@asklepios.com
Thüroff
Joachim W
JW
D002432:Cecum / Q000601:surgery; D003106:Colon / Q000601:surgery; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007082:Ileum / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D001745:Urinary Bladder Diseases / Q000266:history / Q000601:surgery*; D014547:Urinary Diversion / Q000266:history* / Q000379:methods; D016476:Urinary Reservoirs, Continent / Q000266:history*