Proper use of gastrointestinal tract to achieve continent urinary diversion in 73 patients.

Different segments of the gastrointestinal tract have been used to reconstruct the bladder and all have been reviewed in regard to achieving urinary continence. In 53 patients with detubularized ileocecal cystoplasty, the continence rate, both during the day and night, was 88%, while 95% of the patients were continent during the daytime. In nine patients in whom an ileocecal continent reservoir was made, 100% had dry stoma on intermittent catheterization, both during the day and night. We conclude that detubularization of the right colon has a significant effect in achieving urinary control and making a good low pressure pouch. This has helped us to avoid conduits with their inherent problems. Also, the right colon by virtue of the ileocecal valve has good versatility for use in both anti-incontinence or anti-reflux procedures as needed.