Purpose: We determined the efficacy of using a rectus fascial sling to revise an angulated efferent limb in patients with continent urinary diversion and difficulty with intermittent catheterization. Materials and Methods: Two spinal cord injured women who underwent modified Indiana pouch urinary diversion required revision of each efferent limb because of difficulty with catheterization. A strip section of anterior rectus sheath was harvested and used to fix the efferent limb in position, assuring freedom from angulation and facilitating catheterization. Results: Both patients remained continent for more than 2 years postoperatively and neither had further difficulties with catheterization or required additional surgery. Conclusions: Use of the rectus fascial sling in continent urinary diversion enables fixation of the efferent limb to facilitate catheterization and enhance continence.
- spinal cord injuries
- urinary diversion
- urinary incontinence
- urinary reservoirs, continent
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