Recto sigmoid pouch for continent urinary diversion in bladder cancer

الملخص EN

Between January 1999 and March 2002 we used the recto sigmoid pouch (Mainz Pouch II) for continent urinary diversion following cystectomy in 20 patients (16 males and 4 females) the mean age of the patients was 63 years (ranging from 35 to 70) mean follow up was 7.5 months (range 3-15).

The indications were cystoprostatectomy in male and cystectomy in female due to bladder cancer the pouch was constructed by detubularization and inverted U-Shaped reconfiguration of 20 - 24 cm of the intact rectosigmoid colon.

The ureters were reimplanted into the pouch using antireflux techniques (submucosal tunnel).

At follow-up, all patients were continent during daytime and all of them were dry at night with frequency of evacuation of 1 -3 times in the early post operative period and 1-2 times later on.

Follow up radiologic study I.V.U.

showed one obstructed ureter at the uretero colonic junction and improvement or stabilization of the upper urinary tract in all patients.

In conclusion, the rectosigmoid pouch offers some advantages.

It is socially acceptable by the patient, it is simple technique, there is no need for terminal colostomy and it acts as a low-pressure reservoir and therefore it has no incidence of enuresis.

This techni؟ue could be an alternative to the orthotopic methods of diversion when the latter is contraindicated.