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Related Experiment Videos

Continent urinary diversion. A 5 1/2 year experience.

D G Skinner1, G Lieskovsky, S D Boyd

  • 1Department of Surgery, USC School of Medicine, Los Angeles 90033.

Annals of Surgery
|September 1, 1988
PubMed
Summary

Continent urinary diversion using the Kock ileal reservoir offers a viable alternative for bladder replacement. While complications exist, technical modifications have improved outcomes, enhancing patient quality of life.

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Area of Science:

  • Urology
  • Surgical Reconstruction

Background:

  • Continent urinary diversion is a surgical procedure for bladder replacement.
  • The Kock ileal reservoir has been a method for urinary diversion since 1982.

Purpose of the Study:

  • To evaluate the efficacy and complications of the Kock ileal reservoir for continent urinary diversion.
  • To assess the long-term outcomes of Kock pouch construction and conversion.

Main Methods:

  • Analysis of 531 patients undergoing Kock continent urinary diversion from 1982-1988.
  • Review of early and late complications, including reoperation rates.
  • Evaluation of technical modifications to the Kock pouch.

Main Results:

  • Early complication rate was 16.2% with a 1.9% operative mortality.

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  • Late complication incidence dropped to 22% after modifications in July 1985.
  • The ileal nipple valve mechanism demonstrated 95% efficacy in preventing reflux and ensuring continence.

    • Conclusions:

    • The Kock ileal reservoir remains a preferred option for bladder replacement due to its volume and low internal pressures.
    • The nipple valve is effective, but reoperation is needed in 10-15% of patients.
    • Continent urinary diversion provides a viable long-term solution, improving quality of life and self-image.