A free smooth muscle graft for a continent urinary conduit in dogs.

We constructed a continent, catheterizable urinary conduit using a smooth muscle graft in dogs. One end of an isolated vascularized ileal segment was anastomosed to the bladder dome, and the other end was opened in the abdominal wall. The ileal conduit was tightly encircled with a free seromuscular flap of the ileum in 6 dogs and with a similar flap of colon in 6 other dogs. All smooth muscle grafts were alive 6 months after the operation. Pressure study showed that all but one ileal conduit had a pressure of more than 30 cm of water. Two dogs with a free ileal graft leaked urine when the bladder pressure increased, whereas all dogs with a colonic graft never leaked urine from the stoma. This smooth muscle graft will be available to reinforce the continent action of a plicated or narrowed intestinal tube for a urinary reservoir.