Sigma-rectum pouch (Mainz Pouch II)

Abstract

The Mainz pouch II is a well tol er ated form of con ti nent uri nary di ver sion in terms of mor bidity, pro tec tion of the up per uri nary tract and conti nence rate, even in pa tients aged >65 years. Mainz pouch II was de scribed by Fisch and Hohenfellner in 1991. They viewed the sim plic ity and reproducibility of the op er a tion as one of its ma jor ad van tages. A good con ti nence rates between 93%-100% af ter this pro ce dure has been shown in pre vi ous stud ies. The longer follow up will show whether these high rates of con ti nence can be maintained with increasing age. The Mainz Pouch II serves as a sat is fy ing con ti nent uri nary di ver sion for both sexes in se lected pa tients in terms of qual ity of life. Evalu a tion of over all qual ity of life in pa tients with Mainz pouch II uri nary der i va tion has given en cour ag ing results. Com pli ance and co op er a tion of the pa tients, together with pre op er a tive tests for anal com pe tence, are man da tory to avoid com pli ca tions. The Mainz group re ported that the over all com pli ca tion rate was low and comparable with other tech niques of con tinent uri nary di ver sion. Dur ing the past years mod i fica tions of the orig i nal tech nique have been de scribed. These repre sent an in creas ing in ter est in the procedure. To day, the tech niques of low-pres sure and reservoirs have com pletely re placed clas si cal ureterosigmoidostomy. In this re view ar ti cle the main fo cus is aimed at his tory, com pli ca tions, con ti nence and qual ity of life of pa tients with Mainz pouch II.

Urinary undiversion from a sigma-rectum pouch to a cutaneous urinary stoma as a treatment for severe metabolic disorders post-radical cystectomy: A case report

“…The sigma-rectum pouch (Mainz pouch II), first described by Fisch et al in 1993 (5), is a relatively safe and simple system for urinary diversion. The procedure allows for continent urinary diversion into a low-pressure, high-capacity reservoir created using the rectosigmoid colon (6). Hyperchloremic acidosis and electrolyte disturbances that lead to metabolic disorders (owing to the absorption of urinary metabolites by the intestinal mucosa) are one possible complication of sigma-rectum pouch surgery and require treatment with oral medication (5,7,8).…”