Conversion from colonic conduit into recto-sigmoid pouch (Mainz pouch II).

Abstract

OBJECTIVE:

To report our long-term results of conversion from conduit conversion into a continent anal urinary diversion, as after conduit urinary diversion in childhood, some patients wish to have a later conversion to a continent diversion to avoid external appliances and to improve their quality of life.

PATIENTS AND METHODS:

Between 1992 and 2003, 139 patients had a urinary diversion with a recto-sigmoid pouch (Mainz pouch II), of whom four had a conversion from a colonic conduit diversion to a recto-sigmoid pouch. The mean (range) age at conduit diversion was 5.5 (3-14) years and the mean interval between conduit diversion and conversion to a continent anal diversion was 8 (4-18) years. The mean age at conversion into a Mainz pouch II was 13 (8-32) years and the follow-up afterward was 11.5 (1-13) years. The conversion was done by incorporating the pre-existing colonic conduit into the recto-sigmoid pouch with no ureteric reimplantation.

RESULTS:

There were no early complications; one nephrectomy was required 5 years after conversion because of uretero-intestinal obstruction and pyelonephritis. All other reno-ureteric units remained stable and renal function was maintained. All patients are continent day and night; three require substitution with alkali at a base excess of < -2.5 mmol/L to prevent hyperchloraemia and acidosis.

CONCLUSION:

The recto-sigmoid pouch is a therapeutic option when patients desire conversion from an incontinent type of urinary diversion to a continent type.

• Authors: Sascha Pahernik, Christoph Wiesner, Rolf Gillitzer, Raimund Stein, Joachim W Thüroff
• Journal: BJU international (BJU Int) Vol. 97 Issue 1 Pg. 157-60 (Jan 2006) ISSN: 1464-4096 [Print] England
• PMID: 16336348 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Child
• Child, Preschool
• Colon, Sigmoid (surgery)
• Female
• Follow-Up Studies
• Humans
• Male
• Patient Satisfaction
• Postoperative Complications (etiology)
• Rectum (surgery)
• Retrospective Studies
• Treatment Outcome
• Urinary Bladder Diseases (surgery)
• Urinary Diversion (methods)
• Urinary Reservoirs, Continent