Urinary Diversion Via a Continent Ileal Reservoir: Clinical Results in 12 Patients

Abstract

Urinary diversion via a continent ileal reservoir was performed in 12 patients. An isolated ileal reservoir was constructed using the technique described for patients with a continent ileostomy. The ureters were implanted into an afferent segment provided with a reflux-preventing nipple valve. There were few operative complications and no operative mortality. Late complications involving malfunction of the nipple valves occurred in 8 patients and were corrected surgically. Postoperative followup presently is between 9 mo. and 6 1/2 yr. Two patients died: 1 in an accident and 1 of metastatic bladder carcinoma. The remaining 10 patients are continent and without reflux to the upper urinary tract. The reservoir generally is emptied by intermittent self-catheterization 3-6 times daily. The volume capacity of the reservoir is > 500 ml. Urinary cultures were constantly negative in 7 patients and the contents of the reservoir more or less permanently contained bacteria in 5. Dilatation of the upper urinary tracts, progressive renal deterioration or metabolic disturbances were not encountered. All patients are satisfied with this type of urinary diversion, especially those who have undergone other types of diversion previously.