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Yang-Monti Channel (Monti Ileovesicostomy)

The Yang-Monti channel (Monti ileovesicostomy) is a continent catheterizable channel created by transversely retubularizing a short segment of bowel — most commonly ileum — over a small-caliber catheter to convert a wide, short bowel ring into a longer narrow tube. It is the primary alternative to appendicovesicostomy when the appendix is unavailable, unsuitable, or already committed to a Malone antegrade continence enema (MACE).[1][2][3]

For the design rules behind every catheterizable conduit (flap-valve mechanics, tunnel length, fixation), see Principles of Continent Catheterizable Channels.

Yang-Monti retubularization: Ileal segment, conceptual construction sequence

Opening a short ileal segment and retubularizing across the original axis converts bowel circumference into channel length. Sizes are illustrative; pedicle geometry, catheterization and exact variant construction need technical review. (Original WARWIKI schematic; see the figure source record and review limits.)

Historical Background​

The technique was independently described by Yang (1993) and Monti (1997), hence the combined eponym. Yang demonstrated transverse retubularization of a bowel segment in a canine model; Monti refined and popularized the operation clinically. Early human series followed in the late 1990s.[3][4][5][6]

Indications​

IndicationNotes
Neurogenic bladder (spina bifida, SCI, tethered cord)Most common indication; appendix may be diverted to MACE.[1][2][10]
Bladder exstrophy–epispadias complexAppendix often used previously or absent.[1][2]
Post-cystectomy continent cutaneous urinary diversionAdult continent diversion when appendix is unavailable.[7][8]
Devastated bladder outletOften combined with bladder neck closure and augmentation.[10]
MACE for fecal incontinenceBowel-segment alternative when appendix is needed for the urinary channel.[1][14]
Long ureteral defectsSame retubularization principle applied as a Yang-Monti ileal ureter.[15][16][17]

Surgical Technique​

Bowel-segment isolation and vascular pedicle​

A 2–2.5 cm segment of ileum is isolated 15–20 cm proximal to the ileocecal valve on its mesenteric pedicle. The defining vascular advantage of the Monti is that the mesentery enters the segment centrally, so when the bowel is opened and retubularized transversely, the blood supply runs through the midpoint of the resulting tube and perfuses both ends — while the appendix has its own mesoappendiceal vascular pedicle. Neither arrangement guarantees freedom from ischemia.[5][6]

Two practical extensions of the same principle:

  • Combined channel + augmentation from a single pedicle. A longer ileal segment can be harvested, with 2–2.5 cm separated for the channel and the remainder detubularized as the augmentation patch — all sharing one mesentery. This was used in 34.5% of cases in one large series.[5][6]
  • Sigmoid colon as an alternative segment. When the appendix is allocated to MACE and the dilated sigmoid of a neurogenic-bowel patient is available, a single sigmoid segment yields a tube of approximately 10–15 cm — often enough to reach the umbilicus without a double Monti. Sigmoid was used in 11 of 18 Yang-Monti channels in one series.[1][22]

Ischemic stenosis can require a replacement channel: Castellan reported three affected patients among 25 with 29 urinary or enema tubes at mean 13 months. This is a small mixed cohort, not a general 4–12% risk estimate.[6]

Retubularization​

The bowel is opened along its antimesenteric border with a longitudinal incision, converting the cylinder into a flat rectangular sheet. The sheet is rolled transversely (perpendicular to the original bowel axis) over a 12–16 Fr catheter template and closed with a running absorbable suture (4-0 or 5-0).[5][6][3]

  • A 2–2.5 cm ileal segment yields a tube 5–6 cm long; the tube length equals the original bowel circumference.
  • The luminal caliber is set by the catheter template.
  • Orient the reconfigured segment and vascular pedicle to avoid twisting, tension or catheter obstruction; the cited abstracts do not establish a universal mesenteric-side suture-line rule.

Continence mechanism — the flap-valve tunnel​

The continence mechanism recapitulates the ureterovesical junction flap valve (the Mitrofanoff principle): as the reservoir fills, intraluminal pressure compresses the channel against its backing wall, creating a one-way valve that resists efflux while still permitting catheter passage.[23][24]

Three implantation strategies are in routine use:

TunnelConstructionNotes
Submucosal (intravesical)Bladder is opened; submucosal trough developed between mucosa and detrusor; channel laid in trough; mucosa closed over channel.Aim for ~5 cm tunnel (5:1 tunnel-to-diameter, mirroring ureteral reimplantation).[24] Watson urodynamics: functional profile length was associated with continence around 2 cm in 21 mixed conduits; this is not a validated universal cutoff or a Monti-specific surgical length.[25]
Extravesical (Lich-Gregoir–type)3–6 cm detrusor incision; seromuscular flaps brought anteriorly over the channel; no large cystotomy.94% continence in a 84-patient series (37 Monti channels).[26]
Serosa-lined extramural (Ghoneim)Channel positioned on the serosal surface of the augmentation bowel patch; bowel imbricated over it.Useful when the channel must reach the umbilicus — places the tunnel on the augmentation segment rather than native bladder.[8][27]

A 17-adult feasibility study found absence of an initial filled-reservoir pressure peak in the five patients leaking at low detrusor pressure. This supports a role for the intravesical tunnel, but does not establish three universal pressure peaks or show that all incontinent channels lack the same peak.[28]

Bladder-to-abdominal-wall fixation at the channel exit site preserves tunnel length and minimizes angulation as the patient grows or gains weight.[26]

Stoma construction​

The umbilicus is one common option; prioritize reachable, tension-free access in the patient’s usual position over a universal preferred site.[29][30]

  • Triangular skin-flap technique (Bissada): a triangular flap is raised right of the umbilicus, a 1 cm rim of umbilical scar is excised, and the spatulated channel is anastomosed to the apex of the flap, concealing the stoma in the natural umbilical depression.[30]
  • Choose the abdominal-wall course to support easy catheter passage without constriction; the pressure study does not establish mandatory transrectus routing or an independently reliable fascial continence mechanism.[28][9]
  • A flush V-flap stoma is preferred over a protruding stoma to maintain cosmesis and clothing fit.[7][30]

A retrospective series of 60 appendiceal or ureteral channels reported stenosis in 13% of umbilical versus 4% of lower-quadrant stomas. The groups used different channel tissues; the finding is not Monti-specific and does not establish a causal explanation from abdominal-wall thickness.[29]

Channel routing and angulation prevention​

The path from reservoir to skin must be straight and tension-free. Kinking is a leading cause of catheterization difficulty and reoperation.

  • Plan fascial passage and fixation to avoid compression and angulation; do not force a single route across every anatomy.
  • Hitch the bladder dome to the anterior abdominal wall so the tunnel does not elongate as the bladder cycles.[26]
  • Casale (spiral Monti) channels routed to the umbilicus carry a higher subfascial-revision rate (15.2% vs 8.3%) in the retrospective comparison; the study does not establish tortuosity as the causal mechanism.[9]

Variations​

The standard single Monti yields a tube length equal to the circumference of the bowel used — typically only 5–6 cm from a 2–2.5 cm ileal segment. That is often inadequate in adults, in obese patients, or whenever the stoma must reach the umbilicus. Three modifications address this length problem: the double Monti, the Casale (spiral Monti), and the tapered Monti. Sigmoid and gastric segments can be substituted for ileum when needed.

Double Monti​

A composite channel built from two separate 2–2.5 cm ileal segments retubularized independently and anastomosed end-to-end.[6][9][10]

Steps

  1. Select two short ileal segments with preserved vascular attachments; they may be adjacent portions of one harvest. Plan and restore bowel continuity according to the harvest rather than assuming two separate bowel resections are required.
  2. Open each along its antimesenteric border into a flat sheet.
  3. Retubularize each transversely over a 12–16 Fr catheter with a running 4-0 or 5-0 absorbable suture; each yields a 5–6 cm tube.
  4. End-to-end anastomose the two retubularized tubes for a composite channel of ~10–12 cm.
  5. Implant via submucosal, extravesical, or serosa-lined extramural tunnel; flush stoma at the chosen site.

Vascular caveat. Each tube has reliable central mesenteric perfusion in isolation, but the end-to-end anastomosis between them creates an ischemic watershed. Ischemic stenosis was reported in 3 of 25 patients (12%) in the original Castellan/Gosalbez series, all requiring a new channel — The available original abstract does not identify all three as double tubes, so it cannot supply a double-Monti-specific 12% risk.[6]

Use it when

  • Casale is not feasible (limited contiguous ileum from prior bowel surgery).
  • Two different bowel segments are needed for anatomic reasons (one ileal, one colonic).
  • Surgeon preference and familiarity.
  • In Hadley's adult neurogenic-bladder series (n = 26) the double Monti was used in 27% (7/26), with Casale preferred in the remaining 69%.[10]

PGIMER pouch (double-T continent diversion). The double-Monti principle has been carried into continent cutaneous diversion: Yang-Monti tubes are fashioned from the proximal and distal ends of a 45–50 cm ileal segment. The proximal tube serves as the afferent limb for ureteral implantation (Wallace principle); the distal tube(s) function as the efferent catheterizable channel. Both are implanted via serosa-lined extramural tunnels (Ghoneim). In an early 8-patient series, 14 of 15 anastomoses were nonrefluxing, with intestinal obstruction (n = 2) and ureteroileal anastomotic leak (n = 3) early in the learning curve.[8]

Casale (Spiral Monti)​

Described by Casale in 1999, the spiral Monti achieves a long channel from a single piece of bowel on a single mesenteric pedicle, eliminating the watershed anastomosis.[11]

Steps

  1. Isolate a single 3.5 cm ileal segment on its mesenteric pedicle.
  2. Divide the isolated segment transversely into two rings through about 80% of its circumference, leaving the bowel over the mesentery connected. Then open each ring adjacent to the mesentery on opposite sides.[11]
  3. Unfold the bowel into a single long strip whose two halves remain connected through the intact mesenteric bridge — a zigzag/S-shape approximately twice the length of a standard Monti.
  4. Retubularize the strip transversely over a 12 Fr catheter with running absorbable suture, yielding a 10–14 cm tube.
  5. Trim and spatulate the ends as needed for stomal maturation and bladder implantation.

Vascular design. The bridge permits construction without an end-to-end tube anastomosis, but perfusion still depends on careful preservation and untwisted routing. A center-specific preference for tapered ileum is not proof of superior vascular safety.[12]

Tapered Monti​

A tapered ileal channel reduces the caliber of a longitudinal bowel segment and is different from transverse Yang-Monti retubularization. Descriptions vary by reservoir and implantation method; do not conflate it with a single standardized “tapered Monti.” Excisional tapering necessarily opens the bowel wall before closure.[12][33][34]

Galansky's 69-child retrospective study included appendiceal, tapered ileal and enema channels. The tapered ileal channels were performed only by an open approach. Its approximately 91% open-versus-robotic continence figures apply to the mixed groups, not to a robotic tapered-Monti comparison. No direct evidence establishes the strongest blood supply or lowest dilation risk among all three variants.[12]

Comparing lengthening options​

OptionConstructionPractical limitation
Double MontiTwo retubularized short segments joined end-to-endRequires a patent, well-perfused join and adequate reach.
CasaleOne partially divided bowel segment unfolded and retubularizedRequires preservation of its connecting bridge and careful routing.
Tapered ileumLonger segment narrowed along its original axisDifferent construction; bowel use and implantation vary.

Outcomes side-by-side (Riley, n = 188; mean follow-up 43 mo). Standard Monti (n = 109) vs Casale (n = 79):[9]

  • 98% stomal continence overall; the retrospective study was not an equivalence trial.
  • Stomal revision 10.1% (Monti) vs 7.6% (Casale) — not significant.
  • Subfascial revision 9/109 (8.3%) for Monti versus 12/79 (15.2%) for Casale. The paper highlights higher revision with umbilical placement, especially spiral channels; do not infer a causal mechanism or a universally significant overall technique difference from these crude percentages.
  • Endoscopic procedures 9.0% overall, no group difference.

In Hadley's adult series, Casale was preferred in 69% (18/26), double Monti in 27% (7/26).[10]

Choosing the channel​

Measure the required reservoir-to-skin distance, including backed tunnel length. A single Monti is typically only 5–6 cm and cannot be assumed to cover every distance under 10 cm. Choose a longer construction when necessary without stretching the pedicle or leaving excess redundancy. Compare bowel availability, prior operations, stoma accessibility and surgeon experience; published percentages from unrelated cohorts are not a validated decision algorithm.[3][9][11]

In Hadley's 26-adult mixed Monti/Casale cohort, continued self-catheterization was reported in 89%, 50% and 25% across increasing BMI groups. Small, nonrandomized subgroups show that access can be difficult despite an intact channel; they do not prove those rates apply regardless of technique.[10]

Quality of life​

In a 12-adult Casale spiral Monti series at 2.8-year follow-up, all 12 reported excellent continence and very high satisfaction, but two used a light pad over the stoma and only seven could self-catheterize, with two requiring endoscopic dilation for stomal stenosis and 8 of 12 reporting no UTI since surgery — described by patients as improved social independence and bladder management.[35]

Sigmoid and gastric variants​

The Yang-Monti principle has been applied to the sigmoid colon (longer tube from a single segment when ileum is committed elsewhere)[1][22] and gastric tubes have been described for antegrade-enema access. Gastric ACE construction is a different procedure, not proof of a standard gastric urinary Monti.[6][13]

Adults and Obese Patients​

Adults often need greater reach; the Casale (spiral Monti) is one option, not a universal preferred construction. In one adult series with mean BMI 30.5, the proportion successfully self-catheterizing through the umbilical stoma fell with rising BMI and was a major determinant of stomal usability — a practical limitation in morbidly obese patients.[10]

Minimally Invasive Approaches​

Laparoscopic and robotic channels have been described, but the available series do not establish Monti-specific equivalence to open surgery. Rey included only four double Yang-Monti channels among 15 adults; Galansky performed tapered ileal channels only open. Approach-level outcomes from mixed operations should not be presented as a robotic Monti success rate.[12][21]

Catheter Selection and Postoperative Management​

  • 12–14 Fr catheter for routine intermittent catheterization through the channel.
  • An indwelling catheter supports drainage during initial healing; transition to CIC and catheter size are set by the operating team according to healing and concomitant reconstruction, often after several weeks.
  • Regular catheterization is essential; intervals often start around 4–6 hours but must reflect reservoir capacity, urine production and the treating team’s plan. In one retrospective study of mixed urinary/enema channels, poorer adherence was associated with stenosis and revision; it did not test a universal hourly schedule.[32]
  • The historical study used an unusual “greater than 100th percentile” weight category. This should not be presented as a valid modern percentile threshold; assess body habitus and access directly.[32]

Outcomes​

  • Selected cohorts report high stomal continence, often after treatment; results depend on channel type, reservoir and outcome definition.[12][2][18][9]
  • In 199 pediatric patients followed at mean 28 months, 97.5% were still using the channel and leakage was reported in 4/115 assessed for that outcome (3.5%), not 4/199.[18]
  • Small comparative studies did not always detect a continence difference; Lemelle’s 93.8% refers to 61/65 urinary and enema channels still in use, not a Yang-Monti dry rate.[1][9]
  • Mixed open and robotic CCC groups had approximately 91% stomal continence in Galansky; this is not a Monti-specific comparison.[12]

The trade-off lies on the revision side. In Polm 2024 (173 channels, median 12.4 years), 92/173 channels overall required any revision; major revision occurred in 31/51 Monti channels, compared with 27/90 appendiceal and 12/32 bladder-flap channels — underscoring the need for lifelong urological surveillance.[19][20]

Complications​

ComplicationIncidenceManagement
Stomal stenosis8–33% (most frequent; rises with longer follow-up)Dilation; minor revision; V-flap revision for recurrent stenosis.[2][18][31]
Catheterization difficulty~8%Endoscopic intervention; catheter resizing; rerouting.[18]
Channel elongation / angulation, deficient tunnel8–15%Subfascial revision; bladder hitch.[18][9]
False passage~9%Catheterization technique counseling; endoscopic management.[31]
Stomal incontinence3.5–12%Often Deflux (dextranomer/HA) injection; tunnel revision if refractory.[7][31]
Pouch-like channel dilation (Monti-specific)Up to 28% (one series)Catheter adjustment / observation; pouch resection for severe cases.[31]
Recurrent UTIUp to 54% in adultsAntibiotic stewardship; rule out incomplete emptying.[10]
Major surgical revision over very long follow-up31/51 Monti channels in Polm 2024See Outcomes; major means open subfascial or complete revision. Equal applicability to every Casale variant was not demonstrated.[19][20]

The pouch-dilation problem​

Pouch-like dilation occurred in 7/25 Monti channels and was not reported in the appendiceal comparator in one retrospective series. That does not establish that dilation can never occur in another channel. The proposed mechanism is that the circular muscle fibers of the native ileum, oriented circumferentially in the original bowel, run longitudinally in the retubularized tube and so offer little resistance to radial expansion.[31] Prevention strategies include tight retubularization over an appropriately sized (not oversized) catheter, avoidance of redundant bowel length (>2.5 cm), and tapering of the channel to reduce caliber.[12][31]

Yang-Monti Ileal Ureter​

The same retubularization principle is used to bridge long ureteral defects. Two or three 2.5 cm ileal segments are retubularized and anastomosed to create a 12–18 cm tube of ureteral caliber, implanted into the bladder with an antireflux technique. The approach uses less bowel than a conventional long ileal segment, potentially reducing but not eliminating urine–bowel absorption and metabolic consequences — and has shown durable improvement in renal function at median 68-month follow-up. For the broader interposition-graft context see Ileal Ureter.[15][16][17]

See Also​

References​

1. Lemelle JL, Simo AK, Schmitt M. Comparative study of the Yang-Monti channel and appendix for continent diversion in the Mitrofanoff and Malone principles. J Urol. 2004;172(5 Pt 1):1907–1910. doi:10.1097/01.ju.0000140448.36332.fc

2. Cain MP, Casale AJ, King SJ, Rink RC. Appendicovesicostomy and newer alternatives for the Mitrofanoff procedure: results in the last 100 patients at Riley Children's Hospital. J Urol. 1999;162(5):1749–1752. doi:10.1016/s0022-5347(05)68230-4

3. Leslie JA, Dussinger AM, Meldrum KK. Creation of continence mechanisms (Mitrofanoff) without appendix: the Monti and spiral Monti procedures. Urol Oncol. 2007;25(2):148–153. doi:10.1016/j.urolonc.2006.09.007

4. Gerharz EW, Tassadaq T, Pickard RS, et al. Transverse retubularized ileum: early clinical experience with a new second-line Mitrofanoff tube. J Urol. 1998;159(2):525–528. doi:10.1016/s0022-5347(01)63976-4

5. Gosalbez R, Wei D, Gousse A, Castellan M, Labbie A. Refashioned short bowel segments for the construction of catheterizable channels (the Monti procedure): early clinical experience. J Urol. 1998;160(3 Pt 2):1099–1102. doi:10.1097/00005392-199809020-00036

6. Castellan MA, Gosalbez R, Labbie A, Monti PR. Clinical applications of the Monti procedure as a continent catheterizable stoma. Urology. 1999;54(1):152–156. doi:10.1016/s0090-4295(99)00046-1

7. Wagner M, Bayne A, Daneshmand S. Application of the Yang-Monti channel in adult continent cutaneous urinary diversion. Urology. 2008;72(4):828–831. doi:10.1016/j.urology.2008.06.015

8. Agarwal MM, Mavuduru R, Singh SK, Mandal AK. Preliminary short-term outcomes of a modified double-T ileal continent cutaneous urinary diversion using Yang-Monti tube implantation through serosa-lined extramural tunnel: the PGIMER pouch. Urology. 2012;79(4):943–949. doi:10.1016/j.urology.2011.12.026

9. Leslie JA, Cain MP, Kaefer M, et al. A comparison of the Monti and Casale (spiral Monti) procedures. J Urol. 2007;178(4 Pt 2):1623–1627; discussion 1627. doi:10.1016/j.juro.2007.03.168

10. Hadley D, Anderson K, Knopick CR, Shah K, Flynn BJ. Creation of a continent urinary channel in adults with neurogenic bladder: long-term results with the Monti and Casale (spiral Monti) procedures. Urology. 2014;83(5):1176–1180. doi:10.1016/j.urology.2013.12.046

11. Casale AJ. A long continent ileovesicostomy using a single piece of bowel. J Urol. 1999;162(5):1743–1745. PubMed.

12. Galansky L, Andolfi C, Adamic B, Gundeti MS. Continent cutaneous catheterizable channels in pediatric patients: a decade of experience with open and robotic approaches in a single center. Eur Urol. 2021;79(6):866–878. doi:10.1016/j.eururo.2020.08.013

13. Bruce RG, el-Galley RE, Wells J, Galloway NT. Antegrade continence enema for the treatment of fecal incontinence in adults: use of gastric tube for catheterizable access to the descending colon. J Urol. 1999;161(6):1813–1816.

14. Herndon CD, Cain MP, Casale AJ, Rink RC. The colon flap/extension Malone antegrade continence enema: an alternative to the Monti-Malone antegrade continence enema. J Urol. 2005;174(1):299–302. doi:10.1097/01.ju.0000161215.67278.99

15. Ali-El-Dein B, El-Hefnawy AS, D'Elia G, et al. Long-term outcome of Yang-Monti ileal replacement of the ureter: a technique suitable for mild, moderate loss of kidney function and solitary kidney. Urology. 2021;152:153–159. doi:10.1016/j.urology.2020.09.061

16. Liu D, Zhou H, Hao X, et al. Laparoscopic Yang-Monti ureteral reconstruction in children. Urology. 2018;118:177–182. doi:10.1016/j.urology.2018.04.034

17. Ali-el-Dein B, Ghoneim MA. Bridging long ureteral defects using the Yang-Monti principle. J Urol. 2003;169(3):1074–1077. doi:10.1097/01.ju.0000050151.66653.cc

18. Cain MP, Dussinger AM, Gitlin J, et al. Updated experience with the Monti catheterizable channel. Urology. 2008;72(4):782–785. doi:10.1016/j.urology.2008.04.006

19. Polm PD, de Kort LMO, de Jong TPVM, Dik P. Techniques used to create continent catheterizable channels: a comparison of long-term results in children. Urology. 2017;110:192–195. doi:10.1016/j.urology.2017.08.030

20. Polm PD, Christiaans CHH, Dik P, Wyndaele MIA, de Kort LMO. Continent catheterizable urinary channels: lessons for lifelong urological care from a comparative analysis of very long-term complications and revision-free survival of three different types. Neurourol Urodyn. 2024;43(5):1083–1089. doi:10.1002/nau.25350

21. Rey D, Helou E, Oderda M, et al. Laparoscopic and robot-assisted continent urinary diversions (Mitrofanoff and Yang-Monti conduits) in a consecutive series of 15 adult patients: the Saint Augustin technique. BJU Int. 2013;112(7):953–958. doi:10.1111/bju.12257

22. Van Savage JG, Yepuri JN. Transverse retubularized sigmoidovesicostomy continent urinary diversion to the umbilicus. J Urol. 2001;166(2):644–647. doi:10.1097/00005392-200108000-00085

23. Kaefer M, Retik AB. The Mitrofanoff principle in continent urinary reconstruction. Urol Clin North Am. 1997;24(4):795–811. doi:10.1016/s0094-0143(05)70421-3

24. Woodhouse CR. The Mitrofanoff principle for continent urinary diversion. World J Urol. 1996;14(2):99–104. doi:10.1007/BF00182565

25. Watson HS, Bauer SB, Peters CA, et al. Comparative urodynamics of appendiceal and ureteral Mitrofanoff conduits in children. J Urol. 1995;154(2 Pt 2):878–882. doi:10.1097/00005392-199508000-00152

26. VanderBrink BA, Kaefer M, Cain MP, et al. Extravesical implantation of a continent catheterizable channel. J Urol. 2011;185(6 Suppl):2572–2575. doi:10.1016/j.juro.2011.01.027

27. Soygur T, Arikan N, Zumrutbas AE, Gulpinar O. Serosal lined extramural tunnel (Ghoneim) principle in the creation of a catheterizable channel in bladder augmentation. J Urol. 2005;174(2):696–699. doi:10.1097/01.ju.0000164742.04779.cc

28. Christiaans CHH, Polm PD, van Steenbergen TRF, Wyndaele MIA, de Kort LMO. Why are continent catheterizable channels continent? A stomal pressure profilometry feasibility study. Neurourol Urodyn. 2024;43(8):2093–2100. doi:10.1002/nau.25546

29. Van Savage JG, Khoury AE, McLorie GA, Churchill BM. Outcome analysis of Mitrofanoff principle applications using appendix and ureter to umbilical and lower quadrant stomal sites. J Urol. 1996;156(5):1794–1797. doi:10.1097/00005392-199611000-00094

30. Bissada NK. Favorable experience with a simple technique to create a concealed umbilical stoma. J Urol. 1998;159(4):1174–1175.

31. Narayanaswamy B, Wilcox DT, Cuckow PM, Duffy PG, Ransley PG. The Yang-Monti ileovesicostomy: a problematic channel? BJU Int. 2001;87(9):861–865. doi:10.1046/j.1464-410x.2001.02208.x

32. Clark T, Pope JC, Adams MC, Wells N, Brock JW. Factors that influence outcomes of the Mitrofanoff and Malone antegrade continence enema reconstructive procedures in children. J Urol. 2002;168(4 Pt 1):1537–1540; discussion 1540. doi:10.1016/S0022-5347(05)64515-6

33. Kälble T, Roth S. Serosa-lined and tapered ileum as primary and secondary continence mechanism for various catheterizable pouches. J Urol. 2008;180(5):2053–2057. doi:10.1016/j.juro.2008.07.052

34. Figueroa TE, Sabogal L, Helal M, Lockhart JL. The tapered and reimplanted small bowel as a variation of the Mitrofanoff procedure: preliminary results. J Urol. 1994;152(1):73–75. doi:10.1016/s0022-5347(17)32820-3

35. Touma NJ, Horovitz D, Shetty A, et al. Outcomes and quality of life of adults undergoing continent catheterizable vesicostomy for neurogenic bladder. Urology. 2007;70(3):454–458. doi:10.1016/j.urology.2007.04.014