[Functional rectosigmoid neobladder: a new continent urinary diversion].

From 1988 to 1992, six patients underwent surgery to create a functional rectosigmoid neobladder following the technique initially described by Kock and Ghoneim. Four also had a total cystectomy (3 females were submitted to cystourecterectomy). This new continent urinary diversion procedure was performed at the time of reoperation in two previously cystectomized patients with complicated ileal conduits due to ureteroileal stenosis. There were no postoperative deaths. Two cases presented minor complications postoperatively (prolonged paralytic ileus and wall abscess). The follow up period ranged from 3 months to 4 years. All patients were continent during the day and voided every 4 to 6 hours. They were continent during the night and voided once or twice. Preservation of renal function was demonstrable analytically and urographically. The proctogram and proctography disclosed a rectosigmoid neobladder with a big capacity, low pressures and good adaptability to filling. Ureteral reflux was not observed and colosigmoid reflux was minimum, although they did not have the second valve (colosigmoid) of the original technique. Because the procedure is acceptable for the patients and achieves good results, this new alternative continent urinary diversion procedure should be considered for those patients who refuse cutaneous urinary diversion and for those in whom construction of an ileoureteral reservoir is not possible.