The Use of The Appendix or Tapered Ileal Segment as a Continent Cathererizable Efferent Limb of Urinary Reservior

Background and Purpose: We report our functional results of ileal continent reservoir,
which utilized the modified Mitrofanoff procedure as the continence mechanism in 5 invasive
bladder cancer patients post radical cystectomy. Methods: Five invasive bladder cancer patients
accepted radical cystectomy with ileal continent reservoir formation and follow-up ranged from 28
to 99 months (mean 53). Three patients accepted modified appendix and two accepted the ileal
segment tapering as the continent catheterizable efferent limb. One patient died of metastatic
bladder cancer 28 months postoperatively. Results: During the mean follow-up of 53 months, all
the 5 patients were satisfied with the ease of performing self-catheterization through the umbilical
stoma. Urodynamic evaluations revealed low pressure reservoir and stable sphincter tone without
urine leakage. None of patients had stoma stenosis or appendix perforation, catheterization
interval increased from 3 to 5 hours as reservoir capacity developed. Conclusion: The appendix
or tapered ileal segment seem to be the satisfactory structure for the creation of a continent
catheterizable conduit and the placement of stoma in the umbilicus proves to be advantageous in
enhancing the patient's body image and quality of life. ( FJJM 2005; 3 (2) : 69-74 )