Seromuscular trough modification in construction of continent urinary stomas.

The creation of an effective flap-valve continent stoma requires use of supple, catheterizable conduit that is implanted in a submucosal bed having adequate backing. In some patients the backing that has been routinely used, colonic teniae or bladder detrusor for instance, is deficient or unavailable. As an alternative, the seromuscular layers of the recipient urinary reservoir can be simply reconfigured to provide the support required of a continent stoma. The technique has been effective in 4 patients and offers additional flexibility with challenging cases of continent urinary reconstruction.