An appliance-free, sphincter-controlled bladder substitute: the urethral Kock pouch.

Abstract

A modified Kock pouch was constructed in 16 patients with cancer of the bladder in whom cystoprostatectomy was indicated. Surgery entailed creation of a Kock pouch with 1 valve for prevention of reflux. The pouch then was anastomosed to the urethral stump. There was no operative mortality. Followup ranged between 3 and 9 months. Excretory urograms revealed excellent upper tract function and good evacuation of the pouch with minimal residual urine. Urodynamic studies demonstrated a volume capacity of greater than 300 ml., with pressures of less than 40 cm. water. All patients were continent during the day. Nocturnal enuresis was observed in 4 patients, 3 of whom responded favorably to I-desamino-8-D-arginine vasopressin therapy. The procedure is suitable whenever the urethra can be preserved after cystectomy for cancer.

• Authors: M A Ghoneim, N G Kock, G Lycke, A B el-Din
• Journal: The Journal of urology (J Urol) Vol. 138 Issue 5 Pg. 1150-4 (Nov 1987) ISSN: 0022-5347 [Print] United States
• PMID: 3312639 (Publication Type: Journal Article)

Topics

• Adult
• Female
• Follow-Up Studies
• Humans
• Ileum (surgery)
• Male
• Middle Aged
• Postoperative Care (methods)
• Surgical Staplers
• Suture Techniques
• Urethra (surgery)
• Urinary Bladder (surgery)
• Urinary Bladder Neoplasms (physiopathology, surgery)
• Urinary Diversion (methods)
• Urodynamics