Neo-Bladder after Cystectomy

Abstract

When total cystectomy is required in the treatment of bladder tumors or failed bladder exstrophy repair, several methods have been used, all aiming to obtain, at least, socially acceptable urinary continence and avoidance of urinary infection. We present a technique utilizing the lower part of the Colon and rectum. The technique we are about to describe, in which the pulled-through colon, coming from behind, inspired in Nedelec (1898), penetrates the rectum just below the peritoneal reflection, proceeds in a submucosal pathway, to come out through a separate orifice, just behind the anal opening in double fashion, thus maintaining continence but avoiding mixing of urine and faeces.