Orthotopic bladder substitution with detubularized sigmoid colon

Abstract

Introduction: The surgeons who performs substitution cystoplasty should know different techniques utilising the small bowell and sigmoid colon, depending of the local anatomic situation. Materials and methods: A sigmoid colon segment of about 25 cm is isolated. The colic continuity is restored. The isolated segment is put under a "U " shape, it is detubularized and the arms of the "U" are sutured each to the other. The reservoir is anastomosed to the urethra. The urether implantation is performing according to Le Due Carney modified technique and the pouch is closed. Results: From a cohort of 51 patients, this type of cystoplasty have been performed to 23 cases (4 partial detubulized, 19 total detubulized). The postoperative evolution was a good one, continence was relatively good, there were no phenomena of vesico - uretheral reflux. All the patients have had daily continence. 7 patients are incontinent during night time. Conclusions: The sigmoid colon represents a technical variant for bladder substitution to be retained due to its pelvic position, a good vascularization, to easy restoring of the colic continuity, to the urodynamic qualities of the sigmoid bowell, etc.