PMID: 11342890May 9, 2001Paper

The Hadera continent reservoir: a new appendico-umbilical continent stoma mechanism for urinary diversion

The Journal of Urology
Daniel Yachia, N Erlich

Abstract

Creating a reliable continence mechanism for a continent reservoir is a great challenge. We describe an easily formed mechanism for allowing complete continence in such patients. The native appendix attached to a detubularized right colonic reservoir was used as the catheterizable efferent limb. The continence mechanism was created by crossing 2 nondetached right rectus muscle strips around the appendix. At a mean followup of 32 months (range 4 to 52) in 17 patients complete continence was obtained between 2 to 4-hour self-catheterizations in all positions and even during straining. This continence mechanism is easy to construct and creates a reliable continent stoma in all patients who are not candidates for orthotopic bladder replacement and who retain the native appendix. In patients who have undergone appendectomy an alternate method is to create a small caliber efferent limb from a tailored terminal ileum and build the continence mechanism around it.

References

Dec 1, 1986·Journal of Pediatric Surgery·K W Ashcraft, P A Dennis
May 1, 1997·The Journal of Urology·D Yachia
Dec 10, 1997·The Urologic Clinics of North America·J FitzgeraldL N Zinman
Dec 10, 1997·The Urologic Clinics of North America·R Bihrle
Dec 10, 1997·The Urologic Clinics of North America·M Kaefer, A B Retik

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