Improved quality of life and sexuality with continent urinary diversion in quadriplegic women with umbilical stoma

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Researchers, focusing on quality of life issues, offered continent urinary diversion using an umbilical stoma to three women with quadriplegia who required cystectomy for end-stage neurogenic vesical dysfunction complicated by urethra destruction following chronic indwelling catheterization. All three subjects were opposed to having an incontinent abdominal urinary stoma. All three subjects had minimal dexterity, so the umbilicus was chosen as the site of the urostomy because of ease of catheterization and cosmetic appearance. Followup of the subjects ranged from 18-30 months. Reservoir capacity ranged from 550 to 800mL without evidence of reflux or stomal leakage. The incidence of symptomatic autonomic dysreflexia and urinary tract infection decreased in all subjects following surgery. Two of the subjects who were sexually active increased their frequency of sexual activity, and both reported improved sexual enjoyment. In all three subjects body image and satisfaction with urologic management increased.

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