[Long-term evaluation of urinary diversion using a rectal bladder].

Abstract

The long term assessment of urinary diversion by rectal bladder was studied in 18 subjects with a follow-up between 10 and 26 years (mean follow-up: 20 years). The results were evaluated by means of a triple survey: clinical, radiological and laboratory tests. The functional state of the sphincters was assessed, revealing excellent or good results in 13/17 cases for continence of urine during the day, although a lower score was obtained at night, and 14 excellent or good results for continence of faeces. A satisfactory social, professional and sports activity was possible in the majority of cases. An improvement in the results around the age of puberty was observed in 2 cases. The effects on the upper urinary tract was assessed analytically and globally. The global evaluation revealed 32% excellent results, 48% moderate results and 19% poor results. Electrolyte disturbances were only minor and never required treatment. With a follow-up of 20 years, rectal bladder was found to be competitive with other techniques of urinary diversion. It provides satisfactory protection of the kidneys and the generally satisfactory functional results. Furthermore, relatively simple improvements in the operative technique together with the use of sphincter re-education techniques should allow further improvement in the results.