The Transverse ReTubularized IleoVesicostomy is useful as a Continent Urinary Diversion when the appendix is unusable or unavailable for an AppendicoVesicostomy Continent Urinary Diversion.

Eight patients (mean age 29 years) with difficulty Catheterizing their native Urethras underwent creation of a Transverse Retubularized IleoVesicostomy Continent Urinary Diversion to the Umbilicus.

Diagnoses included MyeloMeningocele (3), Multiple Sclerosis (1), and Spinal Cord Injury (4).

Concomitant procedures included Ileocystoplasty, Antegrade Continence Enema Procedure, and PuboVaginal Sling. All patients were able to Catheterize their IleoVesicostomy Conduit and Stoma easily with a 14F catheter.

Six patients were completely dry, and two patients needed to Catheterize every 3 to 4 hours to prevent Urinary leakage. Mean follow-up was 3 years. Experience with the Transverse ReTubularized IleoVesicostomy Continent Urinary Diversion to the Umbilicus has been favorable.

When the Mitrofanoff AppendicoVesicostomy Continent Urinary Diversion is not an option, the Transverse ReTubularized IleoVesicostomy has several advantages as a second choice.

Objectives
Incontinent IleoVesicoStomy is an alternative form of Urinary management applied to patients with NeuroGenic Vesical Dysfunction, who are either unable or unwilling to perform clean intermittent Self-Catheterization or assisted Catheterization.

We review our operative results, Urodynamic data, and complications observed in patients who underwent creation of Incontinent IleoVesicoStomy at our institution.

Methods
Thirteen patients (mean age 43.2 years) with Neurogenic Bladder Dysfunction underwent an Incontinent IleoVesicoStomy between 1994 and 1998.

The Etiologies of the Neurogenic Bladder Dysfunction were

1. Spinal Cord Injury in 8 patients
2. Multiple Sclerosis in 4 patients
3. Tuberculous Meningitis in 1 patient

The preoperative data, surgical records, Urodynamic findings, and postoperative complications were assessed.

Results
All patients experienced complications of their pretreatment Bladder management. The mean operating room time was 242 minutes (range 170 to 395), including 14 additional procedures in 11 patients.

The mean estimated blood loss was 403.8 mL (range 50 to 2000). No patient required blood transfusion. There were no intraoperative complications. Only 1 patient required reoperation for Stomal revision.

One patient had a Ureteral stone 2 years after surgery; 1 patient has continued to have Urinary Tract Infections despite a negative workup. The mean follow-up was 23 months (range 6 to 57). The mean Bladder leak point pressure through the Stoma was 8.2 cm H2O.

Conclusions
The Incontinent IleoVesicostomy is a useful technique in the treatment of patients with Neurogenic Bladder unable to perform clean intermittent Catheterization. It provides patients with a low-pressure Urinary conduit that empties readily without an Indwelling Catheter.