[A technique of continent vesicostomy with ileocystoplasty: study of 32 patients].
OBJECTIVE
To evaluate the functional outcomes and quality of life of adult's disabled motor with neurogenic bladders, who had undergone a continent catheterizable vesicostomy with ileocystoplasty permitting a systematic implantation of the stoma at the umbilicus without closure of the bladder neck.


METHODS
Between 2004 and 2006, 32 adults with neurogenic bladder who underwent Mitrofanoff continent catheterizable vesicostomy with ileocystoplasty were evaluated with the "Qualiveen" and a local satisfaction questionnaire. The median age was 42.2 years. The neurological diagnoses were: spinal cord injury (26), spina bifida (two) and multiple sclerosis (four). The cystostomies were conducted with appendix (17) and the ileum according Monti's technique (15). The stomas were conducted in 29 cases at the umbilicus.


RESULTS
The 31 patients were followed up for a mean of 21.6 months. The continence rate was 86%. The satisfaction with functional result and aesthetic of the stoma was of 88% and 92%. Capacity to self catheterize increased from 64% to 88%. Thirty-three percent of stoma stenosis was noted and 36% of patients underwent a reintervention including 25% for stenosis.


CONCLUSIONS
The results of this study have demonstrated that the ileocystoplasty with umbilical continent vesicostomy fullfill with treatment objective's of patients with neurogenic bladder: restoration of continence and improved quality of life by granting them social life.
Vian
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Service d'urologie, CHU Carémeau, Nîmes, France. manu_vian@yahoo.fr
Soustelle
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Viale
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D000293:Adolescent; D000328:Adult; D000368:Aged; D003559:Cystostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000601:surgery*