title: Colon pouch (Mainz III) for continent urinary diversion.
abstract: OBJECTIVE
  To evaluate the use of a continent cutaneous pouch made exclusively of colon (Mainz pouch III), as excellent results with the Mainz pouch III in irradiated patients suggested that the indication for this type of urinary diversion could be extended.
  
  
  METHODS
  The outcome of 24 patients with continent cutaneous urinary diversions using colon segments (Mainz pouch III) was investigated retrospectively. Overall, 22 of the patients had a malignant disease and two a benign disease; 16 had a hysterectomy and pelvic exenteration for gynaecological tumours; two men with a rhabdomyosarcoma of the prostate had a radical cystoprostatectomy; one woman had pelvic exenteration for bladder cancer; one man had a simultaneous rectum resection due to infiltrating rectal cancer, and another a left nephrectomy with cystectomy for concomitant kidney and bladder tumour. Benign indications were hyper-reflexive bladder after polytrauma and two cases of neurogenic bladder dysfunction. Eighteen patients had radiotherapy (32-48 Gy) before the urinary diversion.
  
  
  RESULTS
  The mean (range) follow-up was 35 (12-65) months. The mean pouch capacity was 293.8 mL. Three patients died during the follow-up (two from disease progression and one suicide); 20 patients were fully continent, four with reduced pouch capacity (<300 mL) had slight incontinence and are wearing a protective pad (band-aid at the umbilicus). All patients use intermittent self-catheterization (mean catheterization frequency 6.8/day, range 6-12). Complications related to the pouch were one outlet stenosis that required revision. Postoperative pouchograms showed asymptomatic reflux in four patients. None of the patients developed metabolic acidosis or diarrhoea.
  
  
  CONCLUSIONS
  The Mainz pouch III is an alternative to other types of continent urinary diversion.
authors.affiliation: Department of Urology, University of Leipzig, Germany. stolj@medizin.uni-leipzig.de
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Stolzenburg
authors.forename: Thilo
authors.initials: T
authors.lastname: Schwalenberg
authors.forename: Evangelos N
authors.initials: EN
authors.lastname: Liatsikos
authors.forename: George
authors.initials: G
authors.lastname: Sakelaropoulos
authors.forename: Kilian
authors.initials: K
authors.lastname: Rödder
authors.forename: Rudolph
authors.initials: R
authors.lastname: Hohenfellner
authors.forename: Margit
authors.initials: M
authors.lastname: Fisch
mesh_terms: D000714:Anastomosis, Surgical; D012809:Colon, Sigmoid / Q000601:surgery*; D039021:Colonic Pouches / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent; D014565:Urogenital Neoplasms / Q000601:surgery*