The Mainz II pouch: experience in 5 patients with bladder exstrophy

Area of Science:

• Pediatric Urology
• Surgical Reconstruction
• Urinary Diversion

Background:

• Bladder exstrophy presents complex reconstructive challenges.
• Urinary diversion is often necessary for patients with small or fibrotic bladders.
• Salvage procedures are crucial for patients with persistent incontinence after multiple surgeries.

Observation:

• This study evaluated 5 patients with bladder exstrophy who underwent creation of a Mainz II pouch.
• The Mainz II pouch was used as primary urinary diversion in 2 patients and secondary diversion in 3 patients.
• Patients underwent multiple surgical procedures, including osteotomy in one case, with yearly postoperative follow-up.

Findings:

• All 5 patients achieved urinary continence.
• The upper urinary tracts remained stable in all patients post-procedure.
• The Mainz II pouch demonstrated success in both primary and secondary urinary diversion settings.

Implications:

• The Mainz II pouch is a suitable option for children with small, fibrotic bladders.
• It serves as an effective salvage procedure for intractable incontinence after multiple reconstructive attempts.
• This technique warrants consideration for pediatric urological reconstruction in developing countries due to its efficacy.