Early experience with the use of gastric segment in lower urinary tract reconstruction in adult patient population.

OBJECTIVES

To review our experience with the potential use of stomach as a substitute to bowel in lower urinary tract reconstruction in adults.

METHODS

Twenty-two adult patients underwent lower urinary tract reconstruction using stomach. Fourteen patients had augmentation cystoplasty, and in 8 patients a continent reservoir was constructed; mean follow-up was 9.8 months. In 6 patients, gastric tube was constructed and used as catheterizable stoma.

RESULTS

Renal functions remained stable or improved in all patients. Two patients developed hypochloremic alkalosis. There was significant decrease in urinary pH. All patients were completely continent, with no problems in mucus production. There was no mortality or significant morbidity.

CONCLUSIONS

Stomach offers a good alternative to ileum or colon for bladder reconstruction. Stomach has various unique advantages, such as less mucus production, acidic milieu in the urine, and protection against hyperchloremic acidosis.