Conversion from incontinent conduit to continent cutaneous reservoir after renal transplant

Objective: To describe the technique and outcomes of conversion of incontinent stoma to continent colonic reservoir after renal transplantation (RT). Methods: From 2004 to 2009, 2 patients who underwent kidney transplants and incontinent stomas underwent takedown of their urostomy with construction of a right colon continent cutaneous pouch with an appendiceal catheterizable stoma. The conduit was used as an afferent limb and anastomosed to the distal ileal portion of the reservoir with ileocecal valve serving as the antireflux mechanism. Thus no ureteral anastomosis was necessary. Results: Both patients had an uneventful postoperative course and are now completely continent. There have been no interval infections or renal graft deterioration with short term follow-up. Conclusion: Continent cutaneous urinary diversion after RT is feasible and can lead to a significant improvement in the quality of life. Further follow-up is necessary to ascertain the long-term results of this form of diversion.