Abstract
The ileo-colic continent pouch in a modified Indiana version has been used in our Unit for some years now on those patients where an orthotopical neo-bladder is impossible. This technique exploits the ileocecal valve's characteristics of continence. The operative stages are indicated, highlighting the main characteristics and unusual technical aspects. We usually use the ascending colon section with supply from ileo-colic artery to obtain a small pouch, which is then enlarged with a 25 cm long detubulised ileal section. The uretero-ileal anastomosis is made by sub-mucosal anti-reflux tunnel. The terminal ileus, which will act as a duct, is anastomised to the umbilical skin, keeping it straight. The choice of umbilical site for the anastomy is excellent for easy self-catheterisation and external appearance. Couch capacity is immediately 600 cc. Urodynamic evaluation shows low pressure in all stages of filling (up to 900 cc) without pressure peaks due to peristaltic contractions.
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