Mazhar Khan, Saadia Muhammad, Farrukh Ozair Shah, Aisha Inam, Ainul Hadi, Muhammad Kalim.
An Experience with Continent Urinary Diversion.
J Surg Pak Jan ;21(2):67-70.

Objective: To find out frequency of urinary continence and surgical complications of using cecum and right colon as reservoir with appendix as a continent catheterizable conduit in various urological conditions in adults. Study design: Retrospective study. Place & Duration of study: Department of Surgery, Hayatabad Medical Complex and Khyber Teaching Hospital, from January 2005 and December 2015. Methodology: This is a review of records of patients who underwent continent urinary diversion. Reservoir was constructed from cecum and right colon using Le Bag technique. Appendix was used as a catheterizable port applying Mitrofanoff principle. Patients were followed up for six months at two months interval. Results: A total of 85 patients underwent continent diversion and 78 patients completed the study protocol. Four patients were lost to follow up and three died. Out of 78 patients, 48 were males and 30 females, with age range from 05 year to 68 year. Thirty-eight (48.71%) patients presented with transitional cell carcinoma, and 12 (15.38 %) had exstrophyepispadias complex. Reservoir formation using right colon with appendix for Mitrofanoff was performed in 53(67.94%) patients. Eleven (14.10%) patients underwent bladder augmentation procedure with Mitrofanoff and in 14 (17.94%) patients appendix alone was used for diversion. Thirty-two (41.02% ) patients developed complications which included incisional hernia (n=7 - 8.97%), calculous formation (n=1 - 1.28%) and subacute intestinal obstruction (n=2 - 2.56%). Conclusion: Use of appendix as a catheterizable conduit is a good option in achieving continent urinary diversion.

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