DETUBULARIZED FOLDED O-SHAPED ILEAL BLADDER

Using a submucosal needle tunneling technique for ureteral implantatio n, detubularized folded O-shaped ileal bladders were created for seven patients in need of bladder replacement. A segment of ileum of only 3 00 to 400 mm in length was required. Anastomosis of. the reservoir to the urethra was simply performed by tailoring the ileum to reduce tens ion at the anastomosis site. Follow-up periods ranged from 24 to 46 mo nths. Excellent upper tract function and good evacuation function with minimal residual urine were demonstrated. Urodynamic studies revealed a mean bladder capacity of 367 mt, with low intra-ileobladder pressur e. All patients are continent during the day. Mild enuresis was noted in three patients. No reflux was noted on follow-up voiding cystoureth rography. This type of ileal bladder is simple to create and provides reliable results. The presence of a short mesentery is not a serious l imiting factor.