Dynamics of a continent caecal reservoir for urinary diversion.

Motor activity of the caecal reservoir for urine, and of the intussuscepted nipple valve in the ileal outlet, was studied in seven continent and two incontinent patients by means of a catheter equipped with two microtransducers. The basal pressure was low in the reservoir even at large-volume filling. In the continent patients the basal pressure was always higher in the ileal outlet than in the reservoir. No high-pressure zone was present in the outlet in the incontinent patients. Intermittent pressure waves occurred in the reservoir, and they increased in frequency, duration and amplitude with increasing filling. Pressure waves with higher amplitude arose simultaneously in the outlet. Increasing time from construction of the reservoir was accompanied by decreasing amplitude of the pressure waves, indicating adaptation towards the larger functional capacity of the reservoir. The recorded dynamics seemed to reflect the functional state of the reservoir.