8. Narayanaswamy, B., Wilcox, D. T., Cuckow, P. M., Duffy, P. G.and Ransley, P. G.: The Yang-Monti ileovesicostomy: a prob-lematic channel? BJU Int, 87: 861, 2001

9. Duckett, J. W. and Lotfi, A. H.: Appendicovesicostomy (andvariations) in bladder reconstruction. J Urol, 149: 567, 1993

10. Cain, M. P., Casale, A. J., King, S. J. and Rink, R. C.: Appendi-covesicostomy and newer alternatives for the Mitrofanoff pro-cedure: results in the last 100 patients at the Riley Children’sHospital. J Urol, 162: 1749, 1999

11. Kaefer, M. and Retik, A. B.: The Mitrofanoff principle in conti-nent urinary reconstruction. Urol Clin North Am, 24: 795, 1997

12. Kaefer, M., Tobin, M. S., Hendren, W. H., Bauer, S. B., Peters,C. A., Atala, A. et al: Continent urinary diversion: theChildren’s Hospital experience. J Urol, 157: 1394, 1997

13. Suzer, O., Vates, T. S., Freedman, A. L., Smith, C. A. andGonzalez, R.: Results of the Mitrofanoff procedure in urinarytract reconstruction in children. Br J Urol, 79: 279, 1997

EDITORIAL COMMENT

The authors have made an important contribution to the field ofreconstructive urological surgery for incontinence. While the datawill not surprise many practitioners in the field, they serve to

reinforce and substantiate the belief that the best planned andexecuted surgeries are completely dependent on patient and fam-ily cooperation after the procedure. The authors provide an im-portant analysis of how patient home care and compliance affectthe complication rate in regard to stomal stenosis and infection,and present trends that indicate that the same correlation willeventually hold up in the area of stone formation. The tenet thatthe most difficult surgical decision is that which matches thepatient to the operation could not be better illustrated than insurgery for incontinence in children. These results can be appliedto all patients who undergo complex urinary reconstruction and,in particular, those who require intermittent catheterization. Thisarticle provides information that will help patients understandthe level of commitment necessary to have success with thissurgery and help surgeons decide which patients are good candi-dates for these procedures.

Anthony J. CasaleDepartment of Pediatric UrologyRiley Children’s Hospital at Indiana UniversityIndianapolis, Indiana

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