Long Term Evaluation Of The Functional Results Of Orthotopic Ileal Bladder Substitutes Integrated With Wall-Incorporated Antireflux Valve

Abstract

Prevention of reflux and maintenance of integrity of upper urinary tract IS one of the most important criteria of ideal bladder substitute. Moreover, a reliable antireflux procedure is so much essential for long term success of any bladder substitute.

Several operative techniques are utilized for reflux prevention. Le Due ureteroileal anastomosis is limited by the ureteric index. It is not suitable for thickened, dilated ureter, also short ureter may make it difficult to perform Le Due technique and caused problems of stenosis and /or reflux in high percentage of patient.

The kock intussuscepted nipple valve has been proved to be an efficient procedure. But high rates of complications and reoperations have been reported. Dessusception of the valve and loss of its function is the most frequent complication.

Also, the serous lined extramural tunnel has been proved to be very efficient procedure for normal non-dilated ureter and not short ureter with low incidence of stenosis and reflux.