Continent Cutaneous Urinary Diversion Using The Full-Thickness Bowel Flap Tube as Continence Mechanism: A Simplified Tunneling Technique

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Abstract
We present a time and labor saving embedding technique for a full-thickness bowel flap tube used as a continent outlet. In 17 patients the bowel flap tube was extramurally embedded instead of being submucosally tunneled. The reservoir was attached to the abdominal wall to reinforce the continence mechanism and prevent the tunnel from opening. All 17 patients are completely continent and 14 of 16 evacuate urine easily with a 14F catheter. Due to recurrent stomal stenosis 1 patient with severe diabetes has undergone incontinent diversion. Our described tunneling procedure for the full-thickness bowel flap tube is easy to perform and provides excellent continence.