Reservoirs and continent conduits
A continent reservoir should have the capacity to retain urine at a low pressure with compliance and little contractile activity. Geometric capacity is achieved by reconfiguring the bowel to resemble a sphere; accommodation occurs as the tension in the wall rises with stable pressure; viscoelasticity enables the segment to be compliant; and detubularization breaks the coordination of bowel contractions. A conduit provides continence and allows catheterization. This may be achieved by luminal compression, peristalsis, equilibration of pressure, or valve action. By making use of the basic principles involved, the surgeon can select the construction most appropriate for the patient.
KeywordsContinent reservoir Conduits Detubularization
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