Ileocoecal augmentation and orthotopic bladder replacement in the management of urinary bladder injury following multiple trauma.

Abstract

The authors offer their experience with the use of the ileocoecal segment for orthotopic bladder replacement (in 7 patients) or augmentation (in 2 patients) in contracted bladders after multilpe trauma. The group of patients was followed up for 6-35 months. In no case did replacement result in adverse metabolic changes, and it was invariably instrumental in normalization of the upper urinary tract, if dilated. By virtue of its hypotonic nature, replacement was not associated with incontinence, with urge incontinence persisting only in patients undergoing augmentation, probably in view of the remaining spacious lower urinary bladder segment with inadequate neurogenic signalization. As both intervention provided patients with a sufficiently long intermicturition intervals thus giving them relative comfort, the response by patients was most favourable.