[A comparative analysis of antireflux and direct methods of ureteral implantation in intestinal continent urinary derivation].

Intestinal continent urinary derivation was made from 1997 to 2006 in three groups of patients. The following kinds of derivation were performed: ureterosygmostomy according to Maintz-Pouch and Abol-Enein modification (group 1, n=32); heterotopic replacement of the urinary bladder in various modifications (group 2, 50 patients); orthotopic replacement according to Hautmann, Studer, Abol-Enein, sygmocystoplasty, n=51). In group 1 ureterosygmoanastomosis was created only by antireflux methods: Goodwin and Hohenfellner submucous technique and Abol-Enein extramural implantation. In groups 2 and 3 uretero-intestinal anastomosis was created by Wallace direct implantation and antireflux--Abol-Enein extramural implantation. The patients were followed up from 6 months to 9 years. The results show that both methods are effective. The antireflux methods are preferable in detubulizing ureterosygmostomy, in extended atonic ureters in case of creation of continent heterotopic and orthotopic reservoirs. The problem of antireflux mechanisms in creation of neobladder needs further investigation.