Kazimierz Krajka, Wojciech Lauer, Marcin Markuszewski, Emilia Pawłowska-Krajka, Marcin Matuszewski
- Katedra i Klinika Urologii AM w Gdańsku
- Introduction. There is a large number of patients after cystectomy who for various reasons does not qualify for ileal bladder. Continent urinary reservoir as an option not requiring wearing any appliances like urostomy plates and bags or not causing inconveniences like rectal bladder is a very attractive solution for some patients.
- Objectives. Presentation of the method.
- Materials and methods. In all cases before planned cystectomy surgeon discusses with a patient possible methods of urinary diversion. Taking into consideration patient's opinion a final decision is made during the operation according to anatomical condition and clinical stage of the disease. The film presents the creation of continent urinary reservoir from ceacum and ascending colon. The colon is prepared with teniomyotomy every 2.5-3 cm. After detubularisation ureters are implanted sub-mucosally for 4 cm. Urostomy was done using end 14 cm long fragment of ileum formed into hydraulic valve along with Guzman method. Its proximal part was sutured into belly button. Ureteral catheters were placed through suture line. The 14 Ch Foley catheter was left in the reservoir.
- Results. The time of the operation is longer than Bricker procedure also performed in similar circumstances for about one hour. Post-operative recovery stay is comparable to other methods of urinary diversion. Capacity of formed reservoirs range from 250 to 400 ml. Hydraulic valve made of ileum secures full continence and easy catheterisation.
- Conclusions. Continent urinary reservoir in our own modification utilising Galucci's (cecum with teniomyotomy) and Guzman (hydraulic valve) is a vary attractive option for urinary diversion