BOWEL-FLAP TUBES FOR CONTINENT CUTANEOUS URINARY-DIVERSION

The appendix stoma for Mainz-pouch continent cutaneous urinary diversi on is reliable and easy to perform. Two new continence mechanisms were developed for patients in whom the appendix is not available or usabl e. A seromuscular tube was used in 27 patients (12 women, 15 men, mean age 63 years) and a bowel-wall tube was used in 24 patients (13 women , 11 men, mean age 57 years) as the continence mechanism for continent cutaneous urinary diversion. At a mean follow-up of 32 months (range 2-68 months), 93% of patients with a seromuscular tube and 92% of thos e with a bowel-wall tube are continent day and night. Four early and n ine late stoma-specific complications have occurred, requiring seven o pen surgical revisions. Thus far, both techniques have fulfilled all r equirements as continence mechanisms for continent cutaneous urinary d iversion. However, the reliability, advantages, and disadvantages of t hese techniques have to be confirmed in further long-term studies.