ABSTRACT
Management of neurogenic bladder aims When all conservative treatments fail, urinary diversion (UD) can be offered rather than resorting to indwelling catheters. Continent urinary diversion (CUD) is proposed to patients who are willing to perform intermittent self-catheterization but who are unable to use the native urethra because of upper limb disability, difficulties in reaching or finding the urethra, or urethral destruction. Much of the early morbidity and mortality associated with UD relates to intestinal complications. The fundamental principles of intestinal anastomoses include adequate mobilization, maintenance of blood supply, apposition of mucosa-to-mucosa of the two bowel segments, and creation of a watertight and tensionless anastomotic line. Sutures or staples can be used, both having similar complication rates. Basic surgical principles of ureterointestinal anastomoses are as follows: The stoma is a very important aspect of the surgery.
