ABSTRACT
Intestinal segments have been used in urologic surgery for more than a century. There has been a recent surge in popularity of multiple techniques for urinary diversion including continent catheterization pouches and orthotopic bladder replacement. Because of the variety of techniques available to the urologic surgeon, one must continue to critically evaluate these newer methods. It is only through the understanding and appreciation of past accomplishments that one can better analyze current and future techniques. In this chapter, we review the historical use of bowel in reconstructive urology. Although many excellent reviews on this topic have been written in the past, none have been as complete as that written by Hinman and Weyrauch in 1936.1 They describe the ureterointestinal implantations in three major categories: (i) formation of a fistulous tract between the ureters and intact bowel; (ii) implantation of ureters into a partially excluded segment of intestinal tract; and (iii) implantation of ureters into an artificial bladder formed from a completely excluded portion of intestinal tract. The first and second categories have declined in popularity since Hinman and Weyrauch wrote their classic thesis, and will be referred to in this review as ‘continent urinary diversion with the anal sphincter’. The third category, in contrast, has expanded in popularity, and will be subcategorized into ‘appliance-dependent urinary diversion’, ‘continent urinary diversion’ and ‘orthotopic bladder replacement’.
