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September 20, 1952


Author Affiliations

From the divisions of general surgery and urology of the Department of Surgery, University of Colorado School of Medicine.

JAMA. 1952;150(3):177-182. doi:10.1001/jama.1952.03680030009004

Occasionally it becomes desirable to develop a new outlet for urinary drainage. The indications for such an operation are not numerous but have been increasing in scope with our ability to perform successfully more extensive and radical surgical resections. Currently the most commonly used procedure is ureterosigmoidal anastomosis; however, the incidence of obstruction and ascending infection among adults is high with this procedure, and at best it has not proved to be ideal. Surgeons have made numerous attempts in the past to create an artificial substitute for the bladder, hoping thereby to overcome difficulties inherent in the transplantation of the ureters to the bowel, which is left in continuity. Gilchrist described a procedure in which the terminal ileum and ascending colon were isolated and the ileocecal valve was utilized as a sphincter mechanism.1 This report reviews the subject of substitutes for the urinary bladder and describes our experiences with