Modified Mainz pouch II (Sigma Rectum pouch) urinary diversion: 12 years experience

Area of Science:

• Urology
• Surgical Oncology
• Reconstructive Surgery

Background:

• Urinary diversion is a critical component in managing bladder cancer and other conditions requiring bladder removal.
• The Mainz Pouch II, a type of continent urinary diversion, aims to improve patient quality of life post-surgery.
• Assessing the long-term outcomes, including complications and quality of life, is essential for evaluating surgical techniques.

Purpose of the Study:

• To evaluate the safety and efficacy of the Mainz Pouch II urinary diversion.
• To analyze the incidence of early and late postoperative complications associated with the Mainz Pouch II.
• To assess the impact of the Mainz Pouch II procedure on patient quality of life.

Main Methods:

• Retrospective analysis of 67 patients who underwent the modified ureterosigmoidostomy (Mainz Pouch II) between 1995 and 2006.
• Mean follow-up of 18 months for 56 patients (84%) to assess complications and quality of life.
• Utilized a clinical questionnaire to gather specific data on urinary diversion outcomes.

Main Results:

• Early complications (n=9, 13%) included urine leakage (7%) and ileus (6%). Late complications (n=19, 28%) involved pyelonephritis (18%) and anastomotic stenosis (11%).
• Continence rate was high at 96%. Metabolic acidosis required oral alkalizing agents in 33% of patients, with two deaths due to severe acidosis.
• Global quality of life was reported as good in 54% of patients, acceptable in 38%, and poor in 8%.

Conclusions:

• The Mainz Pouch II procedure is a simple and safe option for continent urinary diversion.
• It demonstrates favorable complication rates, continence, and quality of life outcomes.
• Successful outcomes depend significantly on appropriate patient selection and diligent postoperative follow-up.