Further experience with the ileocecal segment in urinary reconstruction

Abstract

In selected patients it is possible and desirable to reconstruct a normal or near normal method of urinary drainage after temporary ileal loop urinary diversion or after cystectomy for nonurothelial pelvic malignancy. Satisfactory results have been achieved in 20 of 23 patients, with followup as long as 10 years. Seven patients have undergone reconstruction after temporary ileal conduit urinary diversion for benign conditions. One patient underwent urinary reconstruction following prolonged ileal conduit urinary diversion for radiation-induced injury to the bladder as part of treatment for cervical carcinoma. In 11 patients the ileocecal segment was used as part of a planned urinary reconstructive procedure after cystectomy for nonurothelial pelvic malignancy or when correcting a benign lower urinary tract pathologic condition that resulted in a cutaneous fistula. The ileocecal segment is a surgical unit that allows replacement or augmentation of the bladder, with the ileum substituting for as much ureteral length as necessary. However, the ileocecal valve is not effective in the long-term prevention of reflux and use of a recently described ileal intussusception technique seems preferable.