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Further experience with the urethral Kock pouch.
M A Ghoneim1, A A Shaaban, M R Mahran
1Department of Urology, Mansoura University, Egypt.
The Journal of Urology
|February 1, 1992
Summary
The Kock pouch offers high daytime continence (92%) and good nighttime dryness (73%) in men after radical cystectomy. This bladder substitute procedure shows favorable outcomes for suitable male patients.
Area of Science:
- Urology
- Surgical Oncology
- Reconstructive Surgery
Background:
- Radical cystectomy for bladder cancer necessitates bladder substitution.
- The Kock pouch is a type of ileal neobladder used for urinary diversion.
- Evaluating long-term functional outcomes of the Kock pouch is crucial.
Purpose of the Study:
- To assess the efficacy and safety of the urethral Kock pouch as a bladder substitute.
- To evaluate continence rates and upper urinary tract stability post-cystectomy.
- To determine the suitability of the Kock pouch for male patients preserving the urethra.
Main Methods:
- Construction of a urethral Kock pouch in 185 men undergoing radical cystectomy.
- Follow-up evaluation of 117 patients for at least 1 year.
- Assessment of daytime and nighttime urinary continence, upper tract configuration, and complications.
Main Results:
- High daytime continence (92%) and good nighttime dryness (73%) achieved.
- Upper urinary tract stability or improvement noted in 90% of renal units.
- Complications included reflux (16 units) and anastomotic stricture (8 units); antireflux valve stability was enhanced.
Conclusions:
- The urethral Kock pouch is a recommended bladder substitute for select male patients.
- Favorable continence and upper tract stability support its use after cystectomy.
- Preservation of the urethra is key for successful Kock pouch reconstruction.