Studer’s orthotopic bladder substitution

Abstract

Introduction: The continent urinary reservoirs connected to the urethra have known in the last decade a formidable development. A variant of these ones is the cystoplasty of Studer type. Materials and Methods: About 60 cm of ileum is isolated and the small intestine is restored. The isolated intestinal segment is put under a “J" form, so that 22 A 22 cm should become the urinary reservoir and about 17 cm will be the part of the intestine in which the urethers are implanted. The declive portion is made under "U" form and is detubulized on a portion as long as about 44 cm. The arms of the “U" form are sutured each other with 3 PDS and so an intestinal plate is obtained which is perpendicularly double-fold plicatured on the first suture. The reservoir is closed, a lateral stoma of about 1 cm is practised which is anastomozed to the urethra on a 20 Ch catheter, after the ureteral implanting on 6 Ch splints and the closing of the intestinal segment will be made. Results: In a group of 51 patients this type of cystoplasty has been used in 15 cases. Conclusions: The postoperative course was uneventfull. In 3 cases the patients have had nocturnal incontinence. All of the 15 patients are continent all day long.