Study of Efferent Tube Suspension as a Continent Diversion Mechanism

Abstract

Purpose: To construct a reliable continent tube, which is easy to catheterize and surgically simple. Materials and Methods: 8 adult female mongrel dogs underwent a procedure in which an ileal segment was tapered as an efferent tube. The tapered ileum was fixed to the back surface of the rectus muscle with a polyester taper 1.5 cm in width and a suspension tension of 400 g. The internal orifice of the tapered ileum was anastomosed to the bladder and the external orifice of the tapered ileum was brought out to the abdominal skin. Urodynamic and radiological studies were carried out postoperatively in all dogs. Results: All stomas in dogs could be easily catheterized with a 14-french catheter. Urodynamic study of the efferent tubes showed that the maximum closure pressure ranged from 117 to 157 (mean 136.75) cm water. Retrograde radiogram of the efferent tubes showed perfect canalization without stenosis. Conclusion: This study suggests that the continent mechanism of the tapered ileum can be greatly enhanced by a suspension technique.