Continent ileocecal augmentation cystoplasty.

OBJECTIVES

To evaluate the use of the ileocecal bowel segment for bladder augmentation in a select group of patients who need a low pressure, high capacity urinary storage mechanism and a continent, catheterisable, cutaneous stoma that, because of their physical limitations, is easier to catheterize than their native urethra.

METHODS

We reviewed records of 23 continent ileocecal augmentation cystoplasties performed over the last 5 1/2 years. The goals of the operation, patient selection criteria, pre-operative evaluation, operative technique, and post-operative evaluation with results were studied.

RESULTS

Twenty-three patients underwent the procedure with the average follow-up being 26.9 months (range 3-67 months). Bladder capacity was increased by an average of 276.8 milliliters (ml). No metabolic problems have been detected, and 95% (22/23 patients) are continent via their urethra and stoma.

CONCLUSIONS

This unique modification of the Indiana continent urinary reservoir is not technically difficult to create and is relatively free of complications. The bladder capacity is greatly increased and post-operative continence rates are excellent. Finally, the quality of life for these patients has been significantly improved by their ability to access the augmented bladder independently via an abdominal stoma.