Experience with a detubularized right colonic segment for bladder replacement.

A detubularized right colonic segment was used as bladder substitute in ten men who underwent cystoprostatectomy for carcinoma of the bladder. Postoperative complications unrelated to the replacement procedure occurred in three cases. Stricture of the urethrocaecal anastomosis developed during follow-up in one case. Day-time continence with convenient micturition intervals was achieved in all cases. Nocturnal continence was also maintained if the patients awoke once or twice to void. Urodynamic studies revealed adequate capacity, little or no residual urine and pressure waves of low amplitude at high-level filling. The technique employed for creation of a bladder substitute offers the advantage of technical simplicity. The bowel it utilizes is of secondary importance for intestinal absorption, and the result is a low-pressure, capacious neobladder.