Rectodynamic and Radiological Assessment in Modified Mainz Pouch II Cases

Gümüş, Eyüp; Miroğlu, Cengiz; Saporta, L; Başaran, Gürol; Horasanlı, Kaya; Tanrıverdi, Orhan; Karadağ, Haydar

doi:10.1159/000020300

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…In 1996, Gilja et al [33] used the same technique and reported that the mean basal pouch pressure was 19.5 cmH 2 O. In 2000, Gumus et al [34] also used the same technique and reported that the mean basal pouch pressure was 6 cmH 2 O, with no contraction waves except in three patients, with pressures of 17–48 cmH 2 O. The end pressure (when the patient feels abdominal discomfort) was 13.8 cmH 2 O.…”

Section: Discussionmentioning

confidence: 99%

Detubularised isolated ureterosigmoidostomy (Atta pouch): Manometric and radiological studies in a sample of patients

Atta

Boules

Kotb

2014

Arab Journal of Urology

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ObjectivesTo assess whether the detubularised isolated ureterosigmoidostomy (DIUS) technique is safe for urinary diversion after radical cystectomy.Patients and methodsThe study included 10 patients (mean age 61.8 years) with invasive bladder tumour, operated at the Alexandria University, Egypt. The diversion in all patients was through a DIUS, with ureteric reimplantation by an antirefluxing procedure, using an embedded-nipple technique. The patients were evaluated before and after surgery using radiological and manometric studies, and the results analysed statistically using Student’s t-test.ResultsNine of the 10 patients could differentiate between urinary and stool sensation, and evacuate them separately. The mean (range) daytime frequency was 4.1 (3–5) and the mean night-time frequency was 0.5 (0–1). Before and after surgery, the respective mean resting anal pressure was 71 and 74 cmH2O (P = 0.004), the volume at first desire to defecate was 54 and 72 mL (P = 0.004) and the maximum tolerable volume was 140 and 160 mL (P < 0.001). The anorectal inhibitory reflex was lost in all patients after surgery. The mean (SD, range) basal pouch pressure was 5 (3.33, 0–10) cmH2O, and the end pressure was 13.2 (4.42, 9–20) cmH2O.ConclusionAlthough the Mainz II pouch has a documented efficacy for urinary diversion after radical cystectomy, the modifications we applied to the DIUS improved that method of diversion, by separating urine and stool evacuation, maintaining continence, and with a low frequency and better protection of the upper urinary tracts, resulting in an improvement in the patients’ quality of life.

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Section: Discussionmentioning

confidence: 99%

Detubularised isolated ureterosigmoidostomy (Atta pouch): Manometric and radiological studies in a sample of patients

Atta

Boules

Kotb

2014

Arab Journal of Urology

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“…In recent years, improved bowel preparation techniques, antibiotics and new absorbable suture materials have stimulated renewed interest in ureterosigmoidostomy. The sigma‐rectum pouch (Mainz pouch II), created by detubularizing the rectosigmoid colon, combines continent urinary diversion with a low‐pressure, high‐capacity reservoir, which reduces rates of complications such as uretero‐colonic anastomotic strictures, hyperchloraemic acidosis, recurrent pyelonephritis, and incontinence [7,8]. However, there is a high frequency of upper UTIs in patients with Mainz pouch II because of reflux of urine and feces.…”

Section: Discussionmentioning

confidence: 99%

Clinical experience in a modified Roux‐Y‐ shaped sigmoid neobladder: assessment of complications and voiding patterns in 43 patients

et al. 2010

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D-Y.L. and F.F. are co-first authors.ureterosigmoidostomy using the Leadbetter method. This pouch method has not been described before. The patients' clinical, biochemical, radiological and urodynamic variables were assessed. RESULTSDuring the mean (range) follow-up of 24 (6-65) months, there were no deaths related to the procedure. In 16% of the patients, early complications occurred, whereas 12% had late complications. There were no cases with local recurrence and metastasis. Routine electrolyte evaluation revealed a slight metabolic acidosis in six patients (14%). Hypovitaminosis B 12 did not occur in any patients. All patients were continent in the daytime and night-time continence was poor in eight patients (19%). The mean ( SD , range) neobladder capacity and residual urine volume was 330 (110, 120-410) mL and 48 (26, 25-80) mL, respectively. Moreover, the maximum urinary flow rate was 9.2-25.3 mL/s. CONCLUSIONThe modified Roux-Y-shaped sigmoid neobladder replacement provides a new simple surgical procedure with low complication rates. The procedure offers comparatively satisfactory daytime continence with low postvoid residual urine volumes and voiding patterns. This technique is a valid alternative to continent urinary diversion. KEYWORDScontinent urinary diversion, sigmoid, ureterosigmoidostomy, neobladder, complication Study Type -Therapy (case series) Level of Evidence 4 OBJECTIVETo evaluate the complications and urinary voiding patterns in patients with a new Roux-Y-shaped continent neobladder, using a modified sigmoid pouch.

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“…Inzwischen gibt es eine ganze Reihe von Publikationen, die über exzellente funktionelle Resultate mit dieser Art des kontinenten Urinreservoirs nach radikaler Zystektomie berichten [5,9]. Weitere wesentliche Vorteile sind der extrem geringe Blutverlust und der ebenfalls sehr geringe Wasser-und Elektrolytverlust während des gesamten Eingriffs.…”

Section: Mainz Pouch IIunclassified

Laparoskopische radikale Zystektomie mit intrakorporaler Anlage einer kontinenten Harnableitung Zukunft oder Gegenwart?

et al. 2002

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Once laparoscopic radical prostatectomy has been mastered, the step to performing a radical cystectomy is not that far. The challenge is to create the urinary diversion by laparoscopy. In this report we describe our experience with 11 laparoscopic radical cystectomies and intracorporeal construction of a continent urinary diversion (Mainz pouch II) as a treatment option in patients with muscle-invading bladder cancer. All 11 procedures could be performed successfully. A conversion to open surgery was not required in any case. The mean surgery time was 6.7 h. Except for two pouch fistulas we did not observe any intra- or postoperative complications. The functional as well as the oncological results are convincing. Less morbidity and faster recovery are the main advantages of this minimally invasive procedure. In addition, the low levels of blood loss, fluid shifts, and electrolyte loss considerably reduce cardiovascular stress. Radical cystectomy and construction of a continent urinary diversion represent the limit of technically feasible laparoscopy and should be done exclusively in specialized centers.

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Rectodynamic and Radiological Assessment in Modified Mainz Pouch II Cases

Cited by 8 publications

References 9 publications

Detubularised isolated ureterosigmoidostomy (Atta pouch): Manometric and radiological studies in a sample of patients

Detubularised isolated ureterosigmoidostomy (Atta pouch): Manometric and radiological studies in a sample of patients

Clinical experience in a modified Roux‐Y‐ shaped sigmoid neobladder: assessment of complications and voiding patterns in 43 patients

Laparoskopische radikale Zystektomie mit intrakorporaler Anlage einer kontinenten Harnableitung Zukunft oder Gegenwart?

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