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April 5, 1958


Author Affiliations

Charleston, S. C.

From the Medical Center Hospitals and the Medical College of South Carolina. Dr. Franzblau is now with the Laconia Clinic, Laconia, N. H.

JAMA. 1958;166(14):1722-1724. doi:10.1001/jama.1958.62990140005010b

In recent years many excellent techniques have been developed for urinary tract diversion after surgical excision or because of congenital absence or certain neurogenic disorders of the bladder. In certain patients the bladder itself is intact and able to perform its normal function, but the urine cannot leave the bladder through its normal urethral channel; this condition is found in patients with urethral strictures that recur despite multiple attempts at excision and reconstruction of the urethra. In 1954, Moore1 reported a new technique of lower urinary tract diversion by the creation of a permanent fistula between the rectum and the bladder in the presence of an intact anal sphincter. This he referred to as "vesicorectostomy." On the basis of Moore's initial article, Robbins2 reported several cases in which this procedure was utilized with a slightly modified operative technique. With this information, vesicorectostomy was performed on the patient whose