Continent urostomies: indications and results regarding nine cases.

From January 1990 through June 1998, nine patients underwent continent uros tomies. Indications were bladder cancer in two patients, complex vesicovagi nal fistula which had previously been operated on several times in three su bjects, bladder exstrophy in two, urethral epidermoid carcinoma in one and complex post-traumatic urethral stenosis in one case, The continent stoma c onsisted of the Benchekroun hydraulic ileal valve adapted to an ilio-caecal reservoir in five patients and attached to the bladder in four cases (cont inent cystostomy). The mean follow-up was 36 months (range 14-50 months). N o mortality or early postoperative complications were observed. Continence was achieved in all cases (100%), including one patient who had to be reope rated on for valve perforation, There were unfortunately two late complicat ions, i.e., valve perforation due to a catheterization complication (one ca se), bladder stone (in one patient with a continent cystostomy) which was s uccessfully removed using trans-stomal ultrasonic lithotrity, In conclusion , we advocate the use of continent urostomy for patients in a good general state of health, with a long life expectancy, and for whom orthotopic urina ry diversion is not possible. (C) 2000 Editions scientifiques et medicales Elsevier SAS.