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Continent cutaneous diversion
Author(s) -
Fisch Margit,
Thüroff Joachim W.
Publication year - 2008
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.07976.x
Subject(s) - medicine , stoma (medicine) , urinary diversion , pouch , surgery , efferent , urinary continence , afferent , anatomy , cystectomy , bladder cancer , prostate , cancer , prostatectomy
Continent urinary diversion requires the creation of a reservoir, ureteric implantation and establishment of a continence mechanism in the efferent segment. This review is a short overview on the history of different techniques in current use. Reservoirs with high volume and low pressure can be fashioned by antimesenteric opening and spherical reconfiguration of the bowel. Previously, techniques for ureteric implantation were simply transferred to continent urinary diversion. Currently the need for antirefluxive ureteric implantation techniques is questioned and there is a trend towards refluxive implantation. To create a continence mechanism, simple and reproducible procedures. e.g. the incorporation of the efferent segment into the pouch wall (e.g. appendix stoma, flap valve T mechanism, serosal‐lined extramural tunnel) have been developed. Long‐term data for different surgical techniques show excellent continence and acceptable complication rates.