Anal sphincter controlled urinary diversion: an experimental study

Objective We aimed to make a continent neobladder from the caecum and the ascending colon, using the distal ileum as a neourethra which was pulled through the anal sphincter. Method The experiment was carried on six street dogs of which 2 were males and 4 females. In the first stage, only urethral replacement with an ileal segment was done and pulled through the anal sphincter in a female dog to see if anal sphincter would do any help for continence. An ileocaecal segment was used as a neobladder and neourethra in the second step of our experimental study. Results The dog in which the first operation was made gained continence on the 12th postoperative day. No residual urine was found by catheterisation performed after urination. In controls, neither the stoma nor the anastomosis site developed stenosis. The other 5 dogs became continent 12 to 20 days after the catheters were removed, and a great deal of residual urine volume remained in the neobladder. Conclusion Anal sphincter controlled urinary diversion using ileocaecal segment offers us a new hope to achieve continence in the bladder replacements.