Application of the Monti channel in female adult with urethral injuries in pelvic trauma

Objective. To report 3 cases using the Monti ileovesicostomy as a continent catheterizable stoma in women with post-traumatic resulted in loss of the urethra. Materials and Methods. Between April and November 2010, the Monti technique was performed as a reconstructive procedure in 3 female patients at our institution. All cases had history of posterior urethral defect, two motor vehicle accidents, and one pelvic crush injury. Channels were created by transversely reconfigured segment of ileum. The 3 patients age was 20, 41, and 43 years. Indications, technique, complications and outcomes are reported below. Results. Three patients were undergone for transversely re-tubularized ileal segment urinary reconstruction. All of them were evaluated from 5 to 12 months postoperatively. All patients’ postoperative visits to our outpatient gynecological clinic about 3, 6 and 12 months respectively after Monti ileovesicostomy operation revealed no dehiscence, necrosis, stenosis or perforation of the tube. All performed catheterization through the conduit without difficulty. Conclusion. The Monti ileovesicostomy is a new technique for creation of a continent catheterizable stoma. Based on our data, Monti procedure seems to be a valuable technique in patients with complicated urethral defect who cannot be managed with routine urethroplastic techniques. This reconstruction provides another option for a diversion technique in patients with irreparable urethral damage. However, evaluation whether it can be extensively developed still need more investigations with larger number of patients by long-term follow up.