scholarly journals Comparison of Three Types of Continent Urinary Diversions in a Single Center

2004 ◽  
Vol 4 ◽  
pp. 135-141 ◽  
Author(s):  
Cengiz Girgin ◽  
Akif Sezer ◽  
Kutan Ozer ◽  
Huseyin Tarhan ◽  
Ahmet Bolukbasi ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Stone Formation ◽  
Late Complication ◽  
Transitional Cell ◽  
Complication Rates ◽  
Continent Urinary Diversion ◽  
Kock Pouch ◽  
Ileal Loop ◽  
Mainz Pouch Ii

The results including the complication and continence rates for 3 types of continent urinary diversion were evaluated. From 1992 to 1998 we performed 58 continent urinary diversions after radical cystectomy for invasive transitional cell carcinoma (TCC) of the urinary bladder. All three types of continent diversions and ileal loop procedures were discussed and patient preferences were determined. The patient preference rate for continent urinary diversion was 96.6%, and half of these patients wanted to be completely dry. Mean age of the patients was 58.2 years. Of the 58 patients, 9 (15.5%) had a Kock pouch, 15 (25.8%) had a Kock neobladder and 34 (58.6%) had sigmoidorectal pouch (Mainz-II pouch). Early and late complication rates of the three different continent diversions were evaluated. The number of complications, such as urine leakage, pyelonephritis, hydronephrosis, reflux and stone formation, were similar in all three types of diversions. Two (5.9%) Mainz pouch II patients who had stopped oral alkalinization demonstrated severe hyperchloremic acidosis. Spontaneous pouch rupture occurred in 1 of the Kock pouches. Reoperation rates were higher with the Kock pouch and Kock neobladder cases. Daytime continence rates for the Kock pouch, Kock neobladder and Mainz II pouch were 77.7%, 86.7% and 100% respectively. Even though complete dryness may not be achieved in every patient, orthotopic bladder substitution appears to be the best choice after radical cystectomy. Although it carries the risk of life-long oral alkalinization therapy, the Mainz pouch II is associated with an excellent continence rate and may be a good alternative for patients who desire to be dry.

Urinary Calculi as a Late Complication of the Indiana Continent Urinary Diversion: Comparison with the Kock Pouch Procedure

1996 ◽  
Vol 155 (1) ◽  
pp. 66-68 ◽  
Author(s):  
Akito Terai ◽  
Tomohiro Ueda ◽  
Yoshiyuki Kakehi ◽  
Toshiro Terachi ◽  
Yoichi Arai ◽  
...  
Keyword(s):  
Urinary Diversion ◽  
Late Complication ◽  
Urinary Calculi ◽  
Continent Urinary Diversion ◽  
Kock Pouch

Complication Rate after Radical Cystectomy Depends on the Surgical Technique and Patient’s Clinical Status

2021 ◽  
pp. 1-8
Author(s):  
Przemysław Adamczyk ◽  
Paweł Pobłocki ◽  
Mateusz Kadlubowski ◽  
Adam Ostrowski ◽  
Witold Mikołajczak ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Complication Rate ◽  
Tnm Stage ◽  
Complication Rates ◽  
Open Approach ◽  
Invasive Approach ◽  
Asa Score

<b><i>Purpose:</i></b> This study aimed to explore the complication rates of radical cystectomy in patients with muscle-invasive bladder cancer and identify potential risk factors. <b><i>Methods:</i></b> A total of 553 patients were included: 131 were operated on via an open approach (ORC), 242 patients via a laparoscopic method (LRC), and 180 by a robot-assisted procedure (RARC). Patient age, gender, American Society of Anesthesiologists (ASA) score, urinary diversion type, preoperative albumin level, body mass index (BMI), pathological (TNM) stage, and surgical times were collected. The severity of complications was classified according to the Clavien-Dindo scale (Grades 1–5). <b><i>Results:</i></b> The surgical technique was significantly related to the number of complications (<i>p</i> &#x3c; 0.00005). Grade 1 complications were observed most frequently following LRC (52.5%) and RARC (51.1%), whereas mostly Grade 2 complications were detected after ORC (78.6%). Those with less severe complications had significantly higher albumin levels than those with more severe complications (<i>p</i> &#x3c; 0.05). Patients with an elevated BMI had fewer complications if a minimally invasive approach was used rather than ORC. The patient’s general condition (ASA score) did not impact the number of complications, and urinary diversion type did not affect the severity of the complications. Mean surgical time differed according to the urinary diversion type in patients with a similar TNM stage (<i>p</i> &#x3c; 0.005); however, no difference was found in those with more locally advanced disease. Longer operation time and lower protein concentration were associated with higher probability of complication rate, that is, Clavien-Dindo score 3–5. <b><i>Conclusions:</i></b> The risk of complications after RC is not related to the type of urinary diversion, and can be reduced by using a minimally invasive surgical technique, especially in patients with high BMI.

Modification of the Indiana Pouch Ileo-Caecal Cutaneous Continent Urinary Diversion: Tubular Ileal Afferent Limb for Ureteral Anastomosis Has Low Stricture Rate and Allows Ileal Ureter Replacement

2021 ◽  
pp. 1-6
Author(s):  
Rolf von Knobloch ◽  
Marc Seybold ◽  
Hans Peter Fischer ◽  
Monika Kibele ◽  
Wasim Abdul Samad
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Locally Advanced ◽  
Continent Urinary Diversion ◽  
Ileal Segment ◽  
Stricture Rate ◽  
Indiana Pouch ◽  
Anastomotic Strictures ◽  
Ureter Replacement ◽  
Muscle Invasive

<b><i>Objective:</i></b> The aim of the study was to introduce our new modification of the Indiana pouch with a refluxing ureteral anastomosis in a tubular afferent ileal segment of the ileo-caecal urinary reservoir. <b><i>Patients and Methods:</i></b> Between February 2008 and December 2020, we performed a total of 37 modified continent ileo-caecal pouches for urinary diversion when orthotopic bladder substitution was not possible. Hereby, we modified the Indiana pouch procedure with a new refluxing end-to-end ureteral anastomosis into an 8-cm afferent tubular ileal segment. <b><i>Results:</i></b> We performed the modified Indiana pouch in 27 women (73%) and 10 men (27%). The median age of the patients at time of operation was 64 years (43–80 years). To date, the average follow-up is 69 months (3–156 months). In 32/37 cases, we performed the new pouch procedure after radical cystectomy for muscle-invasive bladder cancer and in 1/37 cases after radical cystectomy for locally advanced prostate cancer. In 4 cases, the procedure was performed after total exenteration of the pelvis due to locally advanced bladder, colorectal, or gynaecological cancers. Ureteral anastomotic strictures were seen in 2/37 patients (5.4%) or 2/72 (2.8%) of renal units. <b><i>Conclusions:</i></b> Our modification of the Indiana pouch cutaneous continent urinary diversion with the ureteral anastomosis to a tubular segment of the pouch is easy to perform and effective in reducing the rate of ureteral anastomotic strictures. By lengthening, the afferent tubular ileal segment, it additionally allows easy ureteral replacement.

Health-Related Quality-of-Life Following Modified Ureterosigmoidostomy (Mainz Pouch II) as Continent Urinary Diversion

2004 ◽  
Vol 46 (5) ◽  
pp. 591-597 ◽  
Author(s):  
Patrick J. Bastian ◽  
Peter Albers ◽  
Herbert Hanitzsch ◽  
Giancarlo Fabrizi ◽  
Romano Casadei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Diversion ◽  
Continent Urinary Diversion ◽  
Health Related Quality ◽  
Related Quality ◽  
Mainz Pouch Ii ◽  
Health Related

Urinary Calculi as a Late Complication of the Indiana Continent Urinary Diversion

1996 ◽  
pp. 66-68 ◽  
Author(s):  
Akito Terai ◽  
Tomohiro Ueda ◽  
Yoshiyuki Kakehi ◽  
Toshiro Terachi ◽  
Yoichi Arai ◽  
...  
Keyword(s):  
Urinary Diversion ◽  
Late Complication ◽  
Urinary Calculi ◽  
Continent Urinary Diversion

LAPAROSCOPIC RADICAL CYSTECTOMY WITH CONTINENT URINARY DIVERSION (RECTAL SIGMOID POUCH) PERFORMED COMPLETELY INTRACORPOREALLY:

2001 ◽  
pp. 1863-1866 ◽  
Author(s):  
INGOLF T??RK ◽  
SERDAR DEGER ◽  
BJ??RN WINKELMANN ◽  
BERND SCH??NBERGER ◽  
STEFAN A. LOENING
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Continent Urinary Diversion

Laparoscopic radical cystectomy with continent urinary diversion (rectosigmoid pouch) performed completely intracorporeally: An intermediate functional and oncologic analysis

Urology ◽  
2004 ◽  
Vol 64 (5) ◽  
pp. 935-939 ◽  
Author(s):  
Serdar DeGer ◽  
Robert Peters ◽  
Jan Roigas ◽  
Andreas H. Wille ◽  
Ingolf A. Tuerk ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Continent Urinary Diversion
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