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

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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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Conflict of interest statement

There is no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68135, Mannheim, Germany

    Patrick Honeck, Maurice Stephan Michel, Lutz Trojan & Peter Alken

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  1. Patrick Honeck
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  2. Maurice Stephan Michel
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  3. Lutz Trojan
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  4. Peter Alken
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Correspondence to Patrick Honeck.

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Honeck, P., Michel, M.S., Trojan, L. et al. An alternative continence tube for continent urinary reservoirs: evaluation of surgical technique, pressure and continence study in an ex-vivo model. World J Urol 27, 131–137 (2009). https://doi.org/10.1007/s00345-008-0297-5

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  • DOI: https://doi.org/10.1007/s00345-008-0297-5

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