Continent ileocecal diversion with an unaltered in situ appendix conduit.

PURPOSE

We performed continent urinary diversion using an unaltered, in situ appendix to decrease the risk of appendicocolic manipulation.

MATERIALS AND METHODS

Since September 1994, 19 patients a mean of 46.5 years old underwent continent urinary diversion with an ileocecal segment and an unaltered, in situ appendiceal conduit. In 1 case of a permanent colostomy we performed simple transposition of the appendix on the ileal pouch as a conduit, which to our knowledge is the first reported case.

RESULTS

During the 4 to 24-month followup (mean 12) 17 patients were continent day and night, defined as being completely dry for 3 to 5 hours. Two patients were occasionally incontinent at night. One patient with a history of multiple operations who was completely incontinent achieved complete continence with endoscopic polytetrafluoroethylene (Teflon) injection at the appendicocecal junction.

CONCLUSIONS

This unaltered in situ appendix technique is timesaving, safe, effective and comparable with other methods that provide urinary continence.