A SURGICAL TECHNIQUE COMBINING CONTINENT CUTANEOUS URINARY-DIVERSION AND COMPLETE ILEAL URETERAL REPLACEMENT

Purpose: Defects of the entire urinary tract are sometimes so extensiv e that a colonic conduit appears to be the only viable therapeutic opt ion. However, if an incontinent diversion is unacceptable, an alternat ive must be found. Materials and Methods: We report on a new technique for achieving a continent diversion in which ileocecal intestinal seg ments are used as a continent reservoir and substitute for both ureter s. Results: At 2-year followup excellent results were achieved in term s of renal function, continence and quality of life as confirmed by sy mptomatic evaluation and radiographic investigations. Conclusions: We demonstrate the feasibility of reconstruction of the entire urinary tr act with a continent reservoir using intestinal segments with a pure c olonic pouch and prevalvular ileal segment as a substitute for both ur eters.