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Related Experiment Videos

The Kock pouch: initial experience and complications.

W B Waters, D J Vaughan, R G Harris

    The Journal of Urology
    |June 1, 1987
    PubMed
    Summary
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    The modified Kock continent internal reservoir procedure shows promise for urinary diversion, with no operative mortality and manageable complications. This technique offers a viable alternative for selected patients needing bladder reconstruction.

    Area of Science:

    • Urology
    • Surgical Oncology
    • Reconstructive Surgery

    Background:

    • Urinary diversion is a critical component of treatment for pelvic malignancies and refractory bladder conditions.
    • The Kock continent internal reservoir procedure offers a continent alternative to traditional urinary diversions.
    • Modifications to the Kock pouch aim to improve its reliability and patient outcomes.

    Purpose of the Study:

    • To evaluate the safety and efficacy of the modified Kock continent internal reservoir procedure.
    • To assess early and late complications associated with this urinary diversion technique.
    • To determine the suitability of the modified Kock pouch as an alternative urinary diversion.

    Main Methods:

    • Retrospective review of 15 patients undergoing the modified Kock continent internal reservoir procedure since December 1984.

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  • Procedures included simultaneous anterior exenteration, ileal conduit conversion, and cystectomy for interstitial cystitis.
  • Analysis of operative outcomes, early complications (urinary leak, fistula), and late complications (incontinence, catheterization difficulty).

    • Main Results:

    • No operative mortality was observed in the 15 patients.
    • Early complications included 2 urinary leaks and 1 enteric-Kock pouch fistula, all successfully managed.
    • Late complications involved urinary incontinence due to efferent nipple valve issues in 3 patients, with 2 requiring revision and 1 awaiting it.

    Conclusions:

    • The modified Kock continent internal reservoir procedure demonstrates a favorable safety profile with no operative mortality.
    • While early and late complications can occur, they appear manageable through surgical intervention or patient acceptance.
    • This modified Kock pouch procedure represents a promising alternative for urinary diversion in carefully selected patients.