[Continent cystostomy: monocentric experience].

AIMS

To evaluate the feasibility, the efficiency, the results of continent cystostomy in adult population.

MATERIAL AND METHODS

Retrospective study of patients who underwent a continent cystostomy between 1987 and 2011.

RESULTS

Forty-three patients underwent a continent cystostomy (13 men and 30 women). The mean age at surgery was 53.4±14.6years. The mean BMI was 25kg/m(2). No death in relation with the cystostomy was reported. Thirty-two patients had a neurological pathology (74.4%), 11 a pathology other than neurological (25.6%). A retention bladder was reported for 12 patients (27.9%), 17 (39.5%) were incontinent, and 14 (32.6%) had a mixed symptomatology. All patients had urodynamics and an evaluation of the urinary tract. Nineteen appendicovesicostomy were made, 15 double Monti-procedure, six simple Monti-procedure, three channels were made of an association of ileon and appendix. Seventeen patients underwent an augmentation cystoplasty in combination with the continent catheterizable conduit. The mean follow-up was 47.6±29months. Continence was achieved in 37 patients (86%), two patients underwent a Bricker. Stomal stenosis occurred in eight patients (18.6%), with a median time of 16.1±20.4 months. Leakage occurred after bladder neck closure for two patients (4.6%). Clean intermittent catheterization were performed by 30 patients, catheterization by a care giver for four patients, seven did not use their stomy because of the evolution of their causal pathology, or because of an intercurrent pathology. No difference between the channels (Mitrofanoff versus Monti) was reported.

CONCLUSION

Continent catherizable cystostomy were a feasible method of continent urinary diversion in an adult population. This study demonstrated their feasibility in an adult population and their long-term efficiency with a mean follow-up of 47.6months and 127months for one of them. With a rate of continence upper than 80%, it was an effective technique of urinary diversion associated with intermittent catheterization.