A new continent vesicostomy technique: preliminary report.

Abstract

A continent vesicostomy was constructed without use of segments taken from other organs, providing a continent and esthetically acceptable stoma. We used this technique in 4 female and 3 male patients. A bladder wall flap with the base near the bladder neck was tubularized creating a neourethra. To add to the resting closure pressure at the neourethra this tube was passed through crossed strands separated from the right and left rectus muscles near the pubis. The crossing strands of the rectus muscles provided lateral pressure to the neourethra, which added to the resting closure pressure. The stoma opened at the level of the pubic hair line in 6 patients and under the umbilicus in 1. Mean followup was 28 months (range 3 to 42). During this period all patients remained dry day and night between self-catheterizations. This technique allows for good continence with an easily accessible stoma without use of segments from other organs.