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Related Experiment Videos

100 cases of Mainz pouch: continuing experience and evolution.

J W Thüroff1, P Alken, H Riedmiller

  • 1Department of Urology, Johannes Gutenberg University, Medical School, Mainz, Federal Republic of Germany.

The Journal of Urology
|August 1, 1988
PubMed
Summary

The Mainz pouch, a surgical technique using bowel segments, offers effective urinary reservoir creation. Modifications have improved continence rates for bladder augmentation, substitution, and diversion, with most patients achieving dryness.

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Area of Science:

  • Urology
  • Surgical Techniques
  • Reconstructive Surgery

Background:

  • The Mainz pouch is a surgical technique for creating a urinary reservoir using segments of the cecum, ascending colon, and ileum.
  • Initial applications included bladder augmentation and continent urinary diversion.
  • Indications have expanded to include complete bladder substitution following radical cystoprostatectomy.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of the Mainz pouch procedure for various urological reconstructive needs.
  • To assess the technique's success in bladder augmentation, total bladder substitution, and continent urinary diversion.
  • To report on patient continence, functional results, and complications, including modifications to address initial issues.

Main Methods:

Related Experiment Videos

  • The Mainz pouch procedure involves using 10-15 cm of cecum and ascending colon, plus two ileal loops of similar length.
  • Modifications were made to the continence nipple technique for cosmetic stomal site (umbilicus) utilization.
  • A total of 100 patients underwent the procedure between 1983 and the study period.

    • Main Results:

    • In bladder augmentation (34 patients), 32 achieved complete dryness; 3 required intermittent catheterization.
    • In bladder substitution (15 patients), most achieved daytime dryness, with some nighttime leakage managed by condom urinals.
    • In continent urinary diversion (51 patients), all but 2 achieved dryness, with 2 requiring intermittent catheterization. Nipple prolapse was resolved by staple fixation.

    Conclusions:

    • The Mainz pouch is a versatile and effective technique for urinary reservoir creation, offering good to excellent continence.
    • Surgical modifications have successfully addressed complications like nipple prolapse, enhancing functional outcomes.
    • The procedure provides a reliable option for patients requiring bladder augmentation, substitution, or continent urinary diversion.