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World Journal of Urology
Published in: World Journal of Urology 1/2009

01-02-2009 | Original Article

An alternative continence tube for continent urinary reservoirs: evaluation of surgical technique, pressure and continence study in an ex-vivo model

Authors: Patrick Honeck, Maurice Stephan Michel, Lutz Trojan, Peter Alken

Published in: World Journal of Urology | Issue 1/2009

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Abstract

Objective

Despite the large number of surgical techniques for continent cutaneous diversion described in literature, the creation of a reliable, continent and easily catheterizable continence mechanism remains a complex surgical procedure.

Aim

Aim of this study was the evaluation of a new method for a catheterizable continence mechanism using stapled pig intestine.

Methods

Small and large pig intestines were used for construction. A 3 or 6 cm double row stapling system was used. Three variations using small and large intestine segments were constructed. A 3 or 6 cm long stapler line was placed alongside a 12 Fr catheter positioned at the antimesenterial side creating a partially two-luminal segment. Construction time for the tube was measured. The created tube was then embedded into the pouch. Pressure evaluation of the continence mechanism was performed for each variation. Intermittent external manual compression was used to simulate sudden pressure exposure.

Results

All variations were 100% continent under filling volumes of up to 700 ml and pressure levels of 58 ± 6 cm H2O for large intestine and 266 ml and 87 ± 18 cm H2O for small intestine, respectively. With further filling above the mentioned capacity suture insufficiency occurred but no tube insufficiency. Construction time for all variations was less than 12 min.

Conclusion

The described technique is an easy and fast method to construct a continence mechanism using small or large intestine. Our ex vivo experiments have shown sufficient continence situation in an ex-vivo model. Further investigations in an in-vivo model are needed to confirm these results.
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Metadata
Title
An alternative continence tube for continent urinary reservoirs: evaluation of surgical technique, pressure and continence study in an ex-vivo model
Authors
Patrick Honeck
Maurice Stephan Michel
Lutz Trojan
Peter Alken
Publication date
01-02-2009
Publisher
Springer-Verlag
Published in
World Journal of Urology / Issue 1/2009
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-008-0297-5

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