Results of radical cystectomy with Mainz pouch II diversion (single institution experience)

Evaluation of the peri- and postoperative morbidity in patients who underwent radical cystectomy and sigma-rectum pouch (Mainz pouch II) diversion with curative intent for invasive bladder cancer. We've reviewed 320 patients with invasive bladder cancer who underwnt radical cystectomy with lymphadenectomy and urinary diversion in our clinic from 1988 to 2011. In 134 (41.9%) patients Mainz pouch II diversion was performed. The results and complication rates have been analyzed in these patients. Intraoperaive injury of the rectum occurred in 2 (1.5%) patient, early complications were found in 40 (29.9%) and late complications in - 5 (3.7%) patients. Oral alkalization was necessary in 30 (22.4%) cases. 9 (6.7%) patients were hospitalized because of severe acidosis. Acute pyelonephritis developed in 8 (5.9%) patients. Hydronephrosis developed in 15 (11.2%) cases. In 7 (5.2%) patients dilatation of upper urinary tract was bilateral and in 8 (5.9%) - unilateral. In 4 (2.9%) patients stricture of the ureteral anastomosis was diagnosed. All patients were dry at day time. Only three (2.2%) patients (2 male and 1 female) needed pads at night time. All of these three patients were above 70 years old. Two patients underwent surgical intervention for interintestinal abscess. One patient was operated because of mechanical bowel obstruction 2 month after surgery. Perioperative mortality was 3.7%. Mainz Pouch II has a low morbidity and mortality rates. This form of diversion is method of choice for patients in whom the urethra cannot be used. In selected cases Mainz Pouch II is alternative to other types of continent diversion.