[The functional, augmented rectal bladder. Initial clinical experience with 10 patients].

From August 1988 until March 1990, 10 female patients received an augmented, functional rectal bladder, according to the technique first described by Kock. Indications were a radical cystectomy in 8 and a rediversion from a previously wet stoma in 2 patients. There was no perioperative mortality. Postoperative complications were obstructive pyelonephritis (1 case, treated with a temporary nephrostomy), obstruction at the ileal intussusception (1 case; operative revision) and slipping at the sigmoid nipple (1; no treatment). Intravenous pyelography 2-3 months postoperatively showed 13 normal and 5 slightly dilated renal units. All patients are completely continent by day, 7 are continent by night, 2 wear sanitary pads during sleep due to occasional spotting. Preliminary experience with this new technique is encouraging and warrants further clinical application in patients in whom the external urethral sphincter is not available to provide the continence mechanism.