SEROUS LINED EXTRAMURAL ILEAL VALVE: A NEW CONTINENT URINARY OUTLET

Abstract

Purpose We report the functional results following the use of serous lined extramural valve as an antireflux technique and urinary outlet for continent urinary diversion. Materials and Methods The procedure was performed in 18 men and 5 women. The technique entails fashioning 2 serous lined extramural troughs in a detubularized W-shape ileal reservoir. A tapered ileal segment is embedded in 1 trough as an antireflux valve and the ureters are anastomosed to its proximal end. Another tapered ileal segment or the appendix is embedded in the second trough and acts as a continent cutaneous outlet. Results No operative or postoperative mortality was observed. One patient had prolonged ileus which was treated conservatively. All patients were evaluable with a mean followup of 19 months. All patients but 1 were continent day and night. No catheterization difficulties were reported. Evacuation intervals were 4 to 5 hours. Radiographic evaluation demonstrated a continent complaint reservoir, stable and straight outlet, and absence of pouch and ureteral reflux. Conclusions This procedure is technically feasible, surgically versatile, applicable for urinary diversion or conversion and associated with satisfactory outcome.