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Related Experiment Videos

Kock to urethra: continent functional bladder replacement.

W L Orovan1, I R Davis

  • 1Department of Urology, St. Joseph's Hospital, McMaster University, Hamilton, Ont.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|April 1, 1990
PubMed
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The Kock reservoir offers a stoma-free urinary diversion by connecting an internal reservoir to the urethra, utilizing the natural sphincter for continence and protecting kidneys with an antireflux valve.

Area of Science:

  • Urology
  • Surgical Innovation
  • Reconstructive Surgery

Background:

  • Ileal conduit urinary diversion, established in 1950, is a standard after pelvic exenteration.
  • Continent urinary diversions using bowel segments have gained interest, but typically require catheterizable stomas.
  • The Kock pouch represents an advancement in creating internal urinary reservoirs.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of the Kock low-pressure urinary reservoir for stoma-free urinary diversion.
  • To demonstrate the ability to re-establish urinary tract continuity by anastomosing the reservoir to the posterior urethra.
  • To assess the functional restoration of bladder emptying and renal protection.

Main Methods:

  • Surgical reconstruction utilizing the Kock low-pressure urinary reservoir.

Related Experiment Videos

  • Anastomosis of the internal reservoir to the posterior urethra, employing the urethral sphincter for continence.
  • Construction of an antireflux valve to prevent kidney reflux.
  • Perioperative complication assessment and urodynamic evaluation of 20 patients.

    • Main Results:

    • Successful implementation of 20 stoma-free urinary diversions using the Kock reservoir.
    • Demonstration of functional bladder emptying without the need for a stoma.
    • Urodynamic evidence confirmed restored bladder function and effective continence.
    • Identification and description of perioperative complications.

    Conclusions:

    • The Kock low-pressure urinary reservoir provides a viable stoma-free urinary diversion option.
    • This technique effectively restores urinary tract continuity and function after pelvic exenteration.
    • The procedure leverages natural anatomical structures for continence and renal protection.