Continent ileocecal augmentation cystoplasty

Objectives: To evaluate the use of the ileocecal bowel segment for bladder augmentation in a select group of patients who need a low pressure, high capacity urinary storage mechanism and a continent, catheterizable, cutaneous stoma that, because of their physical limitations, is easier to catheterize than their native urethra. Methods: We reviewed records of 23 continent ileocecal augmentation cystoplasties performed over the last 5 1/4 years. The goals of the operation, patient selection criteria, pre-operative evaluation, operative technique, and postoperative evaluation with results were studied. Results: Twenty-three patients underwent the procedure with the average follow-up being 26.9 months (range 3-67 months). Bladder capacity was increased by an average of 276.8 milliliters (ml). No metabolic problems have been detected, and 95% (22/23 patients) are continent via their urethra and stoma. Conclusions: This unique modification of the Indiana continent urinary reservoir is not technically difficult to create and is relatively free of complications. The bladder capacity is greatly increased and post-operative continence rates are excellent. Finally, the quality of life for these patients has been significantly improved by their ability to access the augmented bladder independently via an abdominal stoma.