The application of continent urinary stomas to bladder augmentation or replacement in the failed exstrophy reconstruction

J. P. Gearhart, D. S. Peppas, R. D. Jeffs

Research output: Contribution to journalArticle

Abstract

Objective To determine the application and success of continent urinary stomas in the failed bladder exstrophy reconstruction. Patients and methods A total of 3 5 patients underwent construction of a continent urinary stoma during bladder replacement or bladder augmentation between 1987 and 1993. The continent stoma was constructed with appendix (19 patients), tapered ileum (2), Benchekroun (12), Indiana (1) and Mainz type stoma (1). Results Three patients required revision of their continent stoma, one for incontinence and two for difficulty in catheterization. Overall, 95% experienced daytime continence on an intermittent catheterization regimen, while 90% were dry at night. The upper tract remained normal in 34 of 3 5 patients. Conclusions While the Benchekroun technique is reliable in producing continence, difficulty with catheterization has been a chronic problem due to stomal stenosis. Our positive experience with using the appendix as a cath‐eterizable conduit into either the bladder template or bowel segment has led us to prefer this method of continent stoma construction in the patient with a failed exstrophy. In the absence of an appendix, our preference is a tapered ileal segment. The failed exstrophy reconstruction can be salvaged with a continent stoma and substitution or augmentation cystoplasty in most patients, thus avoiding urinary diversion.

Original languageEnglish (US)
Pages (from-to)87-90
Number of pages4
JournalBritish Journal of Urology
Volume75
Issue number1
DOIs
StatePublished - Jan 1995

Keywords

  • Exstrophy
  • continent stoma

ASJC Scopus subject areas

  • Urology

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