The transverse colonic reservoir: the Unicamp technique

Objective To present the results of a continent and nonrefluxing transverse colonic urinary reservoir technique. Patients and methods Twenty patients who had received high doses of irradia tion underwent construction of transverse colonic reservoir as a primary fo rm of urinary diversion. Fourteen patients had a vesicovaginal fistula afte r definitive radiation therapy for gynaecological tumours and six had radia tion therapy for invasive bladder cancer as a definitive treatment. They we re followed for a median (range) of 4.5 (1-8) years, Intravenous pyelograph y before diversion showed mild hydronephrosis in 10 patients, Results After diversion, hydronephrosis improved in four patients and no up per tract deteriorated, All but one of the pouchograms showed no ureteric r eflux, All the patients required clean intermittent self-catheterization ev ery 3-4 h, Persistent asymptomatic bacteriuria was present in 14 patients, although clinical urinary tract infections were not reported. A moderate me tabolic acidosis was present in 12 patients, but none required treatment, T he urodynamic evaluation revealed a median (range) reservoir capacity of 45 0 (350-600) mL, with no contractions or contractions of <35 cmH(2)O. Conclusion These results suggest that the Unicamp technique for constructin g a transverse colonic reservoir is a safe and effective diversion, and is recommended as an alternative method for patients treated by pelvic irradia tion.