Urinary Diversion Manners in Advanced Stages of the Urinary Bladder Cancers

Hospital in Timisoara there have been performed 18 radical cystectomies, out of which 14 for primitive neoplasic localization at the level of the urinary bladder and 6 for secondary localization. The elective or associated with other bordering ablations bladder amputation implies to find manners of urinary diversion. The ureteroneocystoplasties have been performed by three procedures: Mainz II reservoir in 14 cases (70%), rectal bladder in 3 cases (15%) and ileal Camey II reservoir in one case (5%). In two cases (10%) of partial cystectomy, the ureters have been re-implanted in the remainder of the bladder. The detubation of the sigmoid ansa by Mainz II technique and of the ileal ansa by Camey II technique have allowed the realization of some low pressure reservoirs which have considerably diminished the complications by ascendant infection. The usage of the natural sphincters as mean of continence has simplified and allowed the urinary diversion execution and acceptance methods.