Correction of incontinent ileocolic urostomy with Kock's nipple valve.
Continent urostomy procedures may be replacing the incontinent ileal or colon conduit as the preferred method of urinary diversion in gynecologic cancer patients. One method of continent urinary diversion utilizes the detubularized ascending and transverse colon as a reservoir with a tapered segment of distal ileum as the stoma through which the patient catheterizes the pouch (Miami pouch). Failures of this procedure have been reported. A case report of such a failure is presented. This patient was managed by replacing the tapered ileal stoma with a Kock intussuscepted nipple valve made from proximal ileum. The patient is now continent. This technique warrants further investigation as a method of treating patients with continent urostomies of various types (Kock, Indiana, Miami, Mainz) that become partially or completely incontinent.
Oliver
J R
JR
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia 30303.
Wheeless
C R
CR
Fakhoury
G
G
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002408:Catheters, Indwelling; D005260:Female; D006801:Humans; D011183:Postoperative Complications; D019736:Prostheses and Implants; D012086:Reoperation; D014549:Urinary Incontinence / Q000209:etiology* / Q000601:surgery; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects*; D014625:Vaginal Neoplasms / Q000601:surgery