TRANSFORMATION OF THE BRICKER TO A CONTINENT URINARY RESERVOIR TO ELIMINATE SEVERE COMPLICATIONS OF URETERO-ILEOSTOMY PERFORMED IN 8 PATIENTS AMONG 200 BRICKER

Between 1969 and 1994 urinary diversion via the ileal loop (Bricker's operation) was performed in 200 patients. After introduction of method s of continent urinary diversion into clinical practice, some of young patients operated in childhood for congenital lower urinary tract mal formations demanded the conversion of the primary diversion. The decis ion was influenced, however, not only by subjective complaints but als o by severe complications having relation to the long-lasting presence of stoma. A modified Mainz pouch I, with a catheterizable stoma was c onstructed in 6 patients with primary uretero-ileostomy made 7 to 22 y ears prior to conversion because of exstrophy of the urinary bladder o r a neurogenic bladder with total urine incontinence. The ileal loop u sed for uretero-ileostomy was detubularized or combined with additiona l segments of ileum and colon. The ileal stoma was connected to the um bilicus. In other two patients suffering from a neurogenic bladder the uretero-ileostomy was converted to an orthotopic ileal pouch. The aut hors present long-term results (1,5 to 7 years) of follow-up with urod ynamic and radiological evaluation. The results both compensate the ur ologist's efforts and enhance the patient's quality of life.