Purpose: We report the functional results following the use of serous lined
extramural valve as an antireflux technique and urinary outlet for contine
nt urinary diversion.
Materials and Methods: The procedure was performed in 18 men and 5 women. T
he technique entails fashioning 2 serous lined extramural troughs in a detu
bularized W-shape ileal reservoir. A tapered ileal segment is embedded in 1
trough as an antireflux valve and the ureters are anastomosed to its proxi
mal end. Another tapered ileal segment or the appendix is embedded in the s
econd trough and acts as a continent cutaneous outlet.
Results: No operative or postoperative mortality was observed. One patient
had prolonged ileus which was treated conservatively. All patients were eva
luable with a mean followup of 19 months. All patients but 1 were continent
day and night. No catheterization difficulties were reported. Evacuation i
ntervals were 4 to 5 hours. Radiographic evaluation demonstrated a continen
t compliant reservoir, stable and straight outlet, and absence of pouch and
ureteral reflux.
Conclusions: This procedure is technically feasible, surgically versatile,
applicable for urinary diversion or conversion and associated with satisfac
tory outcome.