The continent cecal reservoir for urinary diversion

Abstract

Urinary diversion was accomplished through a continent cecal reservoir in 27 patients. An intussuscepted ileal nipple valve was used as a continence-providing principle. To achieve continence and ease of catheterization, several constructional modifications of the valve were required. Satisfactory functional results were obtained with a nipple valve protruding into the cecal cavity, mesenteric exclusion from the valve and, for stability, a fascial strip sling around the nipple base. The ureters were implanted into the cecum using an anti-reflux technique. Complications were sliding of the nipple valve, which necessitated revisional procedures in a substantial number of patients, and stricture of the ureterocecal anastomosis. Renal function was well-preserved after long-term follow-up. The continent cecal reservoir offers a better quality of life than conduit diversion, and can be an attractive alternative to other methods for selected patients at centers with a special interest in this field.