Urinary diversion using the Kock ileal reservoir in patients with irradiated bowel

The creation of a Kock ileal reservoir is the most common method of continent urinary diversion. The procedure utilizes a metre of distal small bowel. Preoperative pelvic irradiation in patients who are to undergo radical cystectomy for invasive bladder cancer frequently results in thickening of the bowel and its mesentery. This change makes construction of the Kock reservoir somewhat more difficult and could theoretically increase the potential for complications. The authors have found, in a series of 16 such cases, that there is no increased complication rate as a result of preoperative irradiation and that this should not be considered a contraindication to the Kock procedure.