Radiographic evaluation of the urethral Kock ileal bladder substitute.
Fifty male patients who had undergone bladder substitution with a urethral Kock pouch after radical cystectomy for bladder cancer, were evaluated in the immediate postoperative period by retrograde pyelography and pouch cystography, and at later follow-up by pouch cystography. Other radiologic procedures (urography, ultrasonography, CT, etc.) were not part of a routine program, but were used when clinically indicated. In 12% a ureteroileal anastomotic leakage was found; the leaks resolved with continued ureteral stenting. Extravasation at the anastomosis between the pouch and the urethra was seen in 55% at the first cystography. It resolved within one month in all cases by simply leaving a catheter in the bladder. On the late cystograms reflux was observed in 6% of patients, whereas stone formation in the pouch was not encountered. A careful radiologic follow-up of patients with urinary diversions is essential to minimize postoperative complications.
Dorph
S
S
Department of Diagnostic Radiology, Herlev Hospital, University of Copenhagen, Denmark.
Steven
K
K
Mygind
T
T
Thomsen
H S
HS
D000328:Adult; D000368:Aged; D015653:Cystectomy; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D014521:Urethra / Q000000981:diagnostic imaging*; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D016476:Urinary Reservoirs, Continent / Q000379:methods / Q000706:statistics & numerical data; D014567:Urography / Q000379:methods