title: [Catheterizable continence mechanisms for various urinary diversion reservoirs: serosa lined and tapered ileum].
abstract: In a retrospective multicenter study of four clinics perioperative complications as well as incontinence and stoma stenosis of serosa-lined tapered ileum as catheterizable continence mechanisms for different urinary diversions were analyzed. Between 2008 and 2012 a total of 40 patients received a continent catheterizablestoma, 15 (37.5%) in combination with continent vesicostomy and closure of the bladder neck due to postoperative incontinence and recurrent stenosis including radical prostatectomy, transurethral resection (TUR) of the prostate, bladder neck incision (n=11), neurogenic bladder with reduced capacity and incontinence (n=2), interstitial cystitis (n=1) and recurrent urethral tumor following ileal neobladder (n=1). Of the patients 25 (62.5%) received this continence mechanism in combination with a modified Mainz pouch I, in 19 patients as primary and in 6 patients as secondary efferent segment for trouble shooting. The complications were subdivided according the Clavien classification. In 29 patients information concerning continence and stenosis were obtained, the median follow-up was 25 months (range 1-111 months). In patients with continent vesicostomy (n=11) the incontinence rate was 9.1% (1/11) and the stenosis rate 18.2% (2/11). In 18 patients with an ileocecal pouch, incontinence and stenosis rates were 0% and 11.1% (2/18), respectively. The presented technique is a safe continence mechanism for various catheterizable continent urinary diversions for both primary and secondary indications.
authors: Klinik für Urologie und Kinderurologie, St. Antonius-Hospital, Akademisches Lehrkrankenhaus der RWTH Aachen, Dechant-Deckers-Straße 8, 52249 Eschweiler, Deutschland. petra.anheuser@sah-eschweiler.de
authors: P
authors: P
authors: Anheuser
authors: J
authors: J
authors: Kranz
authors: S
authors: S
authors: Rausch
authors: G
authors: G
authors: Fechner
authors: S C
authors: SC
authors: Müller
authors: M
authors: M
authors: Braun
authors: J
authors: J
authors: Steffens
authors: T
authors: T
authors: Kälble
mesh_terms: D039021:Colonic Pouches; D006801:Humans; D014546:Urinary Catheterization / Q000295:instrumentation* / Q000379:methods*; D014547:Urinary Diversion / Q000295:instrumentation* / Q000379:methods*; D014549:Urinary Incontinence / Q000601:surgery*