An appliance-free, sphincter-controlled bladder substitute: the urethral Kock pouch.
A modified Kock pouch was constructed in 16 patients with cancer of the bladder in whom cystoprostatectomy was indicated. Surgery entailed creation of a Kock pouch with 1 valve for prevention of reflux. The pouch then was anastomosed to the urethral stump. There was no operative mortality. Followup ranged between 3 and 9 months. Excretory urograms revealed excellent upper tract function and good evacuation of the pouch with minimal residual urine. Urodynamic studies demonstrated a volume capacity of greater than 300 ml., with pressures of less than 40 cm. water. All patients were continent during the day. Nocturnal enuresis was observed in 4 patients, 3 of whom responded favorably to I-desamino-8-D-arginine vasopressin therapy. The procedure is suitable whenever the urethra can be preserved after cystectomy for cancer.
Ghoneim
M A
MA
Department of Urology, University of Mansoura, Egypt.
Kock
N G
NG
Lycke
G
G
el-Din
A B
AB
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D013528:Surgical Staplers; D013536:Suture Techniques; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D014563:Urodynamics