The Turin pouch: a new technique of ileocecal cutaneous continent urinary diversion.
OBJECTIVE
To evaluate the functional results of a new cutaneous continent reservoir, the Turin pouch (TP), consisting of an ileocolonic pouch with an innovative efferent channel (EC).


METHODS
Since 2006, we have performed the TP on 14 patients in whom the appendix was absent. The distal ileum (10 cm) and right colon (40 cm) were isolated. The cecum and right colon were folded to obtain a U-shaped pouch through a stapler detubularization. An artificial EC was created by separating with a stapler a 5-cm tubularized flap of colonic wall and anastomosing this to the umbilicus.


RESULTS
After a mean follow-up of 45 months (range, 12-72 months), 13 patients were alive and 1 died of bladder cancer progression. Early and late complications occurred in 3 and 4 patients, respectively. Daytime continence was 100% and nighttime continence was 93%. No patient has reported stenosis or difficulties in catheterization. Urodynamic studies (12 months postoperatively) showed a mean maximal pouch capacity of 520 mL (range, 360-720 mL), mean end-filling pressure of 23 cm H2O (range, 18-30 cm H2O), and mean EC closing pressure of 65 cm H2O (range, 52-75 cm H2O).


CONCLUSIONS
The TP offers good functional results and could be applied in patients undergoing continent, heterotopic, urinary diversion.
Department of Urology, San Giovanni Bosco Hospital, Turin, Italy.
Giovanni
G
Muto
Emanuele
E
Castelli
Leonardo
L
D'Urso
Giuliana
G
Leucci
Devis
D
Collura
Alessandro
A
Giacobbe
D000368:Aged; D002432:Cecum / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent