الفهرس 
Part I: IntroductionOnly 14 pages are availabe for public view
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Abstract
Purpose: To evaluate long-term functional outcomes after continent cutaneous urinary diversion and to assess the complications of both stoma and pouch together with quality of life assessment and bone mineral density affection. Materials and Methods: The study included 144 patients who underwent continent cutaneous outlet (CCO) between May 1993 and December 2012. Patient records were reviewed for age, sex, indication for surgery and surgical details. All patients were evaluated for continence with emphasis on frequency of clean intermittent catheterization. Stoma related complications are recorded. Bone densitometry is assessed using DEXA scan. Patients and parent satisfaction is assessed using Mansoura Quality of life questionnaire. Results: A total of 120 patients (73 male and 47 female) were evaluable with a median follow-up 10.3 years (range; 6.4 - 25.3 years). Total bladder substitution was performed in 12 patients, augmentation ileo-cystoplasty in 98 and native bladder in 10. Appendix was used as outlet in 74 patients, tapered ileum in 13 and Monti-ileal tube in 33. Stomal revision is reported in 23 patients (19.2%) with significantly lower rate of stomal revision with the appendix (p= 0.014). The final continence rate is 88.3% (with 3-hour interval). Pouch stone reported in 20 (16.7%) with recurrence rate of 35%. Abnormal BMD recorded in 55% of studied patients with tendency of female affection (p=0.03). The majority of our patients (85.8%) are satisfied with urinary diversion.Conclusions: continent cutaneous urinary diversion is a versatile surgical technique with good functional outcomes and patients’ satisfaction. Appendix should be the first choice for construction of the outlet. Long-term follow up is necessary especially for bone mineral loss.