Sigmoid "tail" modification for bladder augmentation.

OBJECTIVES

The sigmoid colon lends itself well to bladder augmentation particularly in patients requiring reimplantation of ureters or Mitrofanoff valves for continence. We have modified the sigmoid augment to improve ease of catheterization and ureteral reimplantation.

METHODS

Seven children underwent sigmoid "tail" bladder augmentation for various indications. Appendix or tapered ileum was used to create the catheterizable stoma. This technique uses a 3 to 5-cm segment of nondetubularized colon, fixed to the abdominal wall to ease catheterization. Durability of the modification and ease of catheterization were assessed.

RESULTS

All patients are dry day and night with intermittent catheterization. One patient with mild leakage has been managed with pseudoefedrine. Postoperative bowel obstruction and abscess developed in 1 patient.

CONCLUSIONS

The sigmoid "tail" modification does not appear to confer increased morbidity and the short nondetubularized segment fixed to the posterior aspect of the anterior abdominal wall stabilizes the catheterizable stoma improving ease of catheterization.