Abdominal Reservoirs for Continent Urinary Diversion

PURPOSE: Abdominal reservoirs with a continent stoma were constructed. MATERIALS AND METHODS: Different types of artificial valves were fashioned. Our original modification for construction of the Kock pouch is described. The main principle of our suggested version is the embedded and plicated valve, foregoing the antireflux afferent loop, with direct ureteral implantation into the reservoir. RESULTS: Of 69 patients 7 died in the postoperative period. Continence was achieved in 58 of the remaining 62 patients (93.5%). All 7 patients with the embedded valve were continent. CONCLUSIONS: The described modifications led to a shorter operating time and simplified certain portions of the operation.