ABSTRACT
Advances in urodynamics have redefined its indications of bladder augmentation, which are more frequent; in all these cases, the question of whether to perform a concomitant trans-appendicular cystostomy should be raised. The bladder fixation on the abdominal wall will make the cystostomy short, rectilinear and “easy to catheterize.” The bladder incision line will depend on bladder size and choices for mobilizing the right lateral side. The appendicular tube is implanted into the bladder by an anti-reflux technique similar to the Glenn–Anderson type of ureterovesical reimplantation. The bladder segment where the appendix is implanted must be firmly fixed to the abdominal wall by three to five stitches with a slowly absorbable 2-0 suture. The choice of doing everything to implant the appendix in the bladder, as well as its solid parietalization in regard to the stoma so that the trajectory is toward the bladder neck, appears to be indispensable in the success of the therapeutic option.
