Kock pouch procedures: continuing experience and evolution in 135 cases

Between April 1985 and January 1989, 135 consecutive patients underwent construction of a Kock pouch (to the skin in 72 patients, a urethral pouch in 45, an ileorectal pouch in 10 and a hemi-Kock pouch augmentation cystoplasty in 8). The operative mortality (30 days) rate was 4.4%. There were 16 early complications (12.4%) leading to 14 reoperations (11%), with a followup of 6 to 60 months. After Kock pouch to the skin, the late complication rate was 26.1% in the Kock-Skinner technique group and 7.4% in the simplified technique group, and 94.2% of the patients were continent. After a urethral Kock pouch daytime continence was achieved in 93% of the patients within 2 months and nighttime dryness was noted in 65% within 3 months. After an ileorectal Kock pouch all patients were continent day and night, as were those after hemi-Kock pouch augmentation, although 5 of the latter patients required intermittent catheterization.