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Related Experiment Videos

Modified ureterosigmoidostomy (Mainz II): a long-term follow-up.

T Nitkunan1, R Leaver, H R H Patel

  • 1Institute of Urology, UCL London, UK.

BJU International
|May 15, 2004
PubMed
Summary

The modified ureterosigmoidostomy (Mainz II) shows good long-term results as a primary procedure for urinary tract reconstruction. However, it is unlikely to restore continence in patients with existing ureterosigmoidostomies who are already incontinent.

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Area of Science:

  • Urology
  • Surgical Reconstruction
  • Oncology

Background:

  • Ureterosigmoidostomy is a surgical procedure for urinary tract reconstruction.
  • The Mainz II is a modified ureterosigmoidostomy technique creating a low-pressure rectal reservoir.
  • This technique has been used in patients with bladder cancer and failed conventional ureterosigmoidostomies.

Purpose of the Study:

  • To evaluate the long-term outcomes of the modified ureterosigmoidostomy (Mainz II) procedure.
  • To assess continence and complication rates in patients undergoing Mainz II reconstruction.
  • To determine the efficacy of Mainz II in primary cases versus revisions.

Main Methods:

  • Retrospective analysis of 17 patients treated with Mainz II between 1994 and 1999.

Related Experiment Videos

  • Patients underwent radical cystectomy for bladder cancer (12) or revision for failed ureterosigmoidostomy (5).
  • Data collected on continence, complications, and follow-up duration (mean 6.4 years).

    • Main Results:

    • Continence was achieved in 10 of 12 bladder cancer patients and 1 of 5 revision patients.
    • Two revision patients required conversion to a colonic conduit due to severe nocturnal incontinence.
    • Complications included hyperchloraemic acidosis (7 patients), pyelonephritis (1), and renal stones (1). No anastomotic neoplasms were observed.

    Conclusions:

    • The Mainz II procedure demonstrates favorable long-term results when utilized as a primary treatment.
    • Detubularizing the rectosigmoid alone is generally insufficient to restore continence in patients with prior ureterosigmoidostomies and existing incontinence.