الفهرس 
Introduction
ComplicationsOnly 14 pages are availabe for public view
 |  | from | 122 |  |  |
| | | from | 122 | | |
Abstract
The aim of this study is to review the functional results in the survived patients who underwent different forms of rectal diversion more than ten years and provide a solid recommendation to revive or to omit these techniques. This study is retrospective evaluation of patients underwent rectal diversion was performed, 171 patients were evaluable out of 1161 operated patients over the last 35 years. The age ranging from 4 - 75 year, with the median age 48 year. There were 117 female and 54 males. Simple rectal bladder was performed in 53 patients, while 82 patients underwent modified rectal bladder and the remaining 36 patients received double folded rectosigmoid bladder. The evaluation including history, clinical examination, upper tract status, metabolic work up including (serum electrolytes and acid base profile) and the quality of life. It has been found that 36.3% of patients had nocturnal incontinence, which was common in those underwent simple rectal bladder 50.9%. Metabolic acidosis was observed in 19% of the treated patients, the least metabolic consequency was observed in the patient with modified rectal bladder. Upper tract evaluation demonstrated pyelonephretic changes in 14.7%, 10.7% and 4.7% among the treated groups respectively. Hydronephrosis due to anastomotic stricture were comparable in the three groups. Reflux to the upper tract was evident in simple rectal 18% and least in modified rectal 2.4%. Based on the results of this investigation the following conclusions can be made: 1. Rectal urinary diversion is currently not the technique of choice when continent urinary diversion is indicated. The late complication is significantly high. 2. The best results were obtained in patients with modified rectal bladder and double folded rectosigmoid bladder. 3. The indication of anal sphincter controlled reservoir should be restricted in those with short life expectancy or when the other techniques are not feasible.M.SC.