Indiana pouch in female patients with spinal cord injury

Objective: We assessed the results of a continent urinary diversion (Indian a pouch) in seven women with severe neurogenic urinary incontinence. Patients and methods: There were seven patients (mean follow-up 28 months), in five of whom a complete Indiana pouch was created. In two the bladder w as augmented with the Indiana pouch, the bladder neck was closed and an umb ilical stoma was created. In three cases the appendix served as outlet wher eas in the other patients a continent catheterisable stoma was created by m eans of a tapered terminal ileum. Results: All the patients were dry (the stoma was continent) and could cath eterise themselves while sitting in a wheelchair There was one complication (bleeding) immediately postoperatively that needed reintervention. The lat e complications were acceptable: in one patient a stone had to be removed f rom the pouch and there was a stenosis of the stoma in two others, There wa s no hyperchloraemic acidosis. Conclusion: The Indiana pouch is a safe and effective method for neurogenic incontinence when all available pharmacological treatments and clean inter mittent catheterisation have failed, It has little impact on the body image , and the independence and social reintegration of the woman is improved.