CONTINENT ILEOCECAL AUGMENTATION CYSTOPLASTY

Objectives: To evaluate the use of the ileocecal bowel segment for bla dder augmentation in a select group of patients who need a lon pressur e, high capacity urinary storage mechanism and a continent, catheteriz able, cutaneous stoma that, because of their physical limitations, is easier to catheterize than their native urethra. Methods: We reviewed records of 23 continent ileocecal augmentation cystoplasties performed over the last 5 1/2 years. The goals of the operation, patient select ion criteria, pre-operative evaluation, operative technique, and posto perative evaluation with results were studied. Results: Twenty-three p atients underwent the procedure with the average follow-up being 26.9 months (range 3-67 months). Bladder capacity was increased by an avera ge of 276.8 milliliters (mi). No metabolic problems have been detected , and 95% (22/23 patients) are continent via their urethra and stoma. Conclusions: This unique modification of the Indiana continent urinary reservoir is not technically difficult to create and is relatively fr ee of complications. The bladder capacity is greatly increased and pos t-operative continence rates are excellent. Finally, the quality of li fe for these patients has been significantly improved by their ability to access the augmented bladder independently via an abdominal stoma.