Indiana pouch in female patients with spinal cord injury.
OBJECTIVE
We assessed the results of a continent urinary diversion (Indiana pouch) in seven women with severe neurogenic urinary incontinence.


METHODS
There were seven patients (mean follow-up 28 months), in five of whom a complete Indiana pouch was created. In two the bladder was augmented with the Indiana pouch, the bladder neck was closed and an umbilical stoma was created. In three cases the appendix served as outlet whereas in the other patients a continent catheterisable stoma was created by means of a tapered terminal ileum.


RESULTS
All the patients were dry (the stoma was continent) and could catheterise themselves while sitting in a wheelchair. There was one complication (bleeding) immediately postoperatively that needed reintervention. The late complications were acceptable: in one patient a stone had to be removed from the pouch and there was a stenosis of the stoma in two others. There was no hyperchloraemic acidosis.


CONCLUSIONS
The Indiana pouch is a safe and effective method for neurogenic incontinence when all available pharmacological treatments and clean intermittent catheterisation have failed. It has little impact on the body image, and the independence and social reintegration of the woman is improved.
Plancke
H R
HR
Department of Urology, De Wever Hospital, Heerlen, The Netherlands.
Delaere
K P
KP
Pons
C
C
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D016476:Urinary Reservoirs, Continent