Favorable experience with a simple technique to create a concealed umbilical stoma

Purpose: After using different sites for continent urinary diversion stomas the umbilicus became the preferred site. Experience with a simple technique to place the continent diversion stoma at the umbilical site is reported. Materials and Methods: Cutaneous continent urinary diversion was performed in 95 patients with placement of the stoma at the umbilical site. A triangular skin flap is elevated to the right of the umbilicus, a 1 cm. piece of the umbilical scar is excised and the apex of the skin flap is anastomosed to the spatulated appendix, tapered ileum or gastric tube. Results: All patients had satisfactory cosmetic results, 3 required simple revision and 4 needed dilation. These 7 patients as well as all others easily catheterized the urinary pouch. Conclusions: This simple technique results in good cosmesis and it is associated with a minimal need for stomal revision.