Previously, we published a new technique for continent urinary diversion, using bladder wall as the catheterizable channel.  Initially, we published on 6 children, all of whom had large bladders that had not previously undergone surgery.  This included patients with disorders such as, posterior urethral valves, Hinman syndrome, Eagle-Barrett syndrome, and spina bifida.  The short term results were  excellent and have been published. At this time we present both intermediate follow-up as well as some expanded indications, including patients with augmented bladders, patients undergoing simultaneous augmentation, and adults. The adults had previously had bladder augmentations as a group, but had difficulties with the stoma.

The previously published six patients were followed for a mean of 40.8 months (range 33 - 48). These were managed long term and continue to be followed. There has been no deterioration of renal function due to the procedure itself or deaths. One child is progressing to transplantation, from pre-existing renal disease.  We originally published on an average follow-up of 6 (range 2 - 12).  We added 6 patients to include 4 children with spina bifida and 2 adults, one 34-years-old with bladder exstrophy and a prior ileocystoplasty and Monti channel and one 36-year-old with sacral agenesis who had undergone an ileocystoplasty with Monti stoma.  Both patients had experienced multiple repeat surgeries for catheterizing issues, and needed another revision. Seven patients underwent a MACE procedure and one patient had a cecostomy, at the time of the continent vesicostomy.

In all, a total of four patients required revision or other procedures, starting from 1-12 months after the procedure.  All complications were stomal stenosis or difficulty catheterizing  Four required dilation only, and one required open revision.  No serious complications observed. THe patients have been followed now for an average of three years and no serious complications are evident.

This procedure should be in the armamentarium of the reconstructive urologist, both of children and adults. It is in the same category as the Mitrofanoff, and the Monti procedures. It is an easily taught procedure and requires no additional bowel.

Over the intermediate term this operation has proven effective and safe.  There were no significant complications related to the procedure.  There are a significant cohort of patients who may benefit from this procedure, to include patients with pre-existing augmentation surgeries or patients undergoing simultaneous augmentation requiring a cutaneous catheterizable stoma.  Comparisons will be made with the traditional methods such as Monti and Mitrofanoff.