Continent urinary diversion in childhood

Continence and a positive body image are important, especially to the adolescent patient. Since 1964 we have used ureterosigmoidostomy and have achieved a complete continence rate of 92.3%. The creation of a low-pressure reservoir by antimesenteric splitting of the recto-sigmoid eliminated many of the shortcomings of ureterosigmoidostomy. This procedure is termed the sigma-rectum pouch and has been applied in six children to date. Mainz-pouch bladder augmentation or substitution has been performed in 20 children, 17 of whom are completely continent. The results of the modified Young Dees procedure were disappointing. In three children, conversion into a continent diversion was necessary. Al…