Document Detail


Functional characteristics of the continent ileocecal urinary reservoir: mechanisms of urinary continence.
MedLine Citation:
PMID:  2795726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We evaluated urodynamically 14 patients with a continent ileocecal urinary reservoir. Reservoirs were constructed of detubularized right colon alone (4 patients), or augmented with ileum (2) or with a U-shaped ileal patch (8). All reservoirs were placed in the abdomen and used plicated terminal ileum as the efferent continence mechanism. Twelve patients are completely continent with intermittent catheterization at 4 to 8-hour intervals. Two patients suffer mild nighttime incontinence. Mean reservoir volume was 675 ml. Intermittent intestinal contractions were noted in the plicated ileal segment and reservoir but they occurred more frequently in the former and were either synchronous with or preceded those in the reservoir. Mean and maximal contraction pressures were 24 and 47 cm. water, respectively, in the reservoir and 40 and 151 cm. water, respectively, in the plicated ileal segment (p equals 0.043 and less than 0.001, respectively). The highest reservoir contractions occurred in the 2 patients with nocturnal incontinence. The method of construction bore no consistent correlation with mean or maximal contraction pressures, contraction frequency or continence. Careful urodynamic assessment suggests that the ileocecal urinary reservoir is a relatively low pressure, nonrefluxing and continent bladder substitute. The plicated terminal ileal segment acts as an effective sphincter that responds to pressure elevations in the reservoir. Its simple construction and easy catheterization make it an attractive alternative to intussuscepted ileal segments.
Authors:
P R Carroll; J C Presti; J W McAninch; E A Tanagho
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of urology     Volume:  142     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  1989 Oct 
Date Detail:
Created Date:  1989-10-31     Completed Date:  1989-10-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1032-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Urology, University of California School of Medicine, San Francisco 94143.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biomechanics
Cecum / surgery*
Electromyography
Female
Humans
Ileum / surgery*
Male
Middle Aged
Urinary Diversion*
Urinary Incontinence / physiopathology,  surgery*
Urodynamics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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