Four types of continent conduit are reviewed. The urethra and its sphincter remain the best option, if the urethral sphincter is spastic, it is either self catheterized or left open for endoscopy and the bladder emptied by a suprapubic continent stoma. Of the other solutions, the Mitrofanoff technique is probably easier to learn but the results are very similar to those of the Kock procedure. New enthusiasm for the use of the anal sphincter has arisen because of the development of a low-pressure rectal reservoir, which has improved continence.
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