[Sigma rectum pouch for urinary diversion].
OBJECTIVE
To investigate the clinical outcome of sigma rectum pouch as a continent form of urinary diversion.


METHODS
The clinical data of 38 patients, 32 males and 7 females, aged 53.2 (42 - 68) with muscle-invading bladder carcinoma who underwent a Mainz pouch II procedure after radical cystectomy 1996 - 2001 were analyzed. The intestine was incised over a length of 20 - 24 cm with the junction of sigmoid colon and rectum as the midpoint so as to create a low-pressure reservoir for urine and side-to-side anastomosis was performed on the posterior borders of the rectosigmoid wall. Submucosal tunnel technique was employed in antireflux urethral implantation. The patients were followed up for 7 - 60 months with a mean of 30 months postoperatively.


RESULTS
Continence has been achieved in all the 38 patients with a micturition frequency of 3 - 5 times during daytime and 0 - 3 times at night. The mean volume of pouch was 515.6 ml (400 - 650 ml). The basal intra-reservoir pressure was 8 - 23 cm H(2)O (mean 16.5 cm H(2)O, 1 cm H(2)O = 0.098 kPa), the highest peak pressure was 12 - 33 cm H(2)O (mean 21.3 cm H(2)O).


CONCLUSIONS
A modified sigmoid rectal pouch procedure provides a reservoir with a higher capacity and lower pressure without a reflux to the upper urinary tract and descending colon with lower incidence of complication, it is also a better alternative diversion procedure that would be easily accepted by surgeons and patients.
Department of Urology, China-Japan Union Hospital, Jilin University, Changchun 130031, China.
Sheng-Wen
SW
Li
Shi-Wei
SW
Zhang
Xiang-Guo
XG
Lin
Kai
K
Zhang
Wei
W
Yang
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D012809:Colon, Sigmoid / Q000502:physiology / Q000601:surgery*; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000502:physiology / Q000601:surgery*; D014513:Ureter / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000601:surgery*; D016476:Urinary Reservoirs, Continent / Q000502:physiology; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods