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Initial results with slightly modified Kock pouch.

N H Bander1

  • 1James Buchanan Brady Foundation, Department of Surgery/Division of Urology, New York Hospital-Cornell Medical Center, New York.

Urology
|February 1, 1991
PubMed
Summary
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This study reviewed 20 patients who underwent Kock pouch continent urinary diversion. Most patients achieved continence, with minor issues like valve leakage and stones successfully managed.

Area of Science:

  • Urology
  • Surgical Procedures

Background:

  • Continent urinary diversion is a surgical option for bladder cancer patients.
  • The Kock pouch is a type of continent urinary diversion that uses the patient's own intestine to create a reservoir.
  • Modifications to the original Kock pouch technique aim to improve outcomes and reduce complications.

Purpose of the Study:

  • To review the initial experience with 20 patients undergoing a modified Kock pouch continent urinary diversion.
  • To assess the safety, efficacy, and complications of this modified procedure.

Main Methods:

  • A retrospective review of 20 patients who underwent Kock pouch continent urinary diversion.
  • The procedure involved a modified technique based on Kock and Skinner's original description.
  • Patients were followed for a minimum of four months, with a median follow-up of 33 months.

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Main Results:

  • No early complications related to the pouch were observed.
  • Incontinence occurred in 10% of patients due to a patulous efferent nipple valve, which was successfully repaired.
  • Other complications included afferent limb prolapse (5%) and stone formation (15%).
  • All patients were continent and stone-free at the end of the follow-up period.

Conclusions:

  • The modified Kock pouch continent urinary diversion is a safe and effective procedure.
  • While complications such as incontinence and stone formation can occur, they are manageable.
  • The majority of patients are satisfied with the functional and cosmetic outcomes.