Ileocecal conduit for temporary and permanent urinary diversion.

The ileocecal intestinal segment has been used as a diverting conduit with a satisfactory colonic stoma in 6 patients with potentially reversible bladder disorders. Followup has been from 1 to 5 years. The ileocecal valve has been modified successfully by a fundoplication procedure similar to the Nissen esophagogastric junction operation to prevent ileocecal and ureteral reflux. IVP and renal function studies revealed resolution of pre-existing hydronephrosis and preservation of previously normal upper urinary tracts. One patient has undergone reversal of the diversion by cecocystoplasty and simultaneous bladder augmentation, and has been followed for 5 years with sterile urine and normal IVPs. The anatomic and functional advantages of a conduit with an antireflux mechanism that is applicable to the hydronephrotic collecting system are discussed.