THE ARTIFICIAL BLADDER: A REVIEW

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Abstract
SUMMARY: The possible advantages of an artificial bladder can be stated briefly. In a small number of cases coming to surgery it may be necessary to leave the patient with a wet colostomy. This is an unpleasant and relatively uncontrollable stoma. It is suggested that having two controllable stomata, one with clean urine draining and the other passing a solid stool once or twice a day, is far better and more sanitary than having a continual leak of a urinary solution of feces. The other advantages are all inherent in the recognised disadvantages of ureterocolic anastomosis, some of which have been so excellently reviewed by Jacobs (1952). The advantages suggested are: (1) by using an isolated segment of bowel one can avoid ascending infection; (2) one can avoid dilatation by using a direct mucosa to mucosa technique without fearing gas or faecal reflux; (3) one can probably avoid biochemical disturbances by having only a small area of bowel bathed in urine and by keeping that empty by continuous drainage. Much of this is as yet unproved hypothesis, but even the small number of observations made so far support the validity of these assumptions.I am indebted to the Honorary Editors of the Proceedings of the Royal Society of Medicine for their kind permission to publish this paper, which was read at a meeting of the Section of Urology on 27th March 1952.