NEW CONTINENCE MECHANISMS FOR CONTINENT U RINARY-DIVERSION BASED ON THE FLAP-VALVE-PRINCIPLE - A CHRONIC ANIMAL STUDY

In chronic animal studies, two new continence mechanisms based on the flap-valve-principle were developed for continent cutaneous urinary di version (Mainz-pouch or other large bowel pouches). In 6 dogs a submuc osal seromuscular tube (group 1) and in another 6 dogs a submucosal bo wel wall tube (group 2) was formed on a proximal colonic segment. The bowel segment was anastomosed to the bladder dome as a continent colov esicostomy and the efferent part of the continence mechanism was impla nted into the abdominal wall. After 2.5 months, the continence mechani sms were investigated macroscopically, functionally (catheterization, uro dynamics) and histologically. Catheterization was successful in 5/ 6 seromuscular tubes and 4/6 bowel wall tubes. In the urodynamic studi es, all catheterizable continence mechanisms were continent without le ak point. In our experimental studies, both the seromuscular tube and the bowel wall tube fulfill all prerequesites (1. uncomplicated surgic al technique, 2. easy catheterization, 3. continence without leak poin t) for a continence mechanism in continent cutaneous urinary diversion .