Right colonic reservoir with submucosally embedded tapered ileum--'Tiflis pouch'

Seventeen patients with invasive bladder cancer aged between 44 and 67 years underwent radical cystectomy and construction of the continent urinary reservoir from 20 to 25 cm cecoascendum reconfigurated a.m. Heineke-Mikulicz. and submucosally embedded tapered ileum as a continence mechanism--'Tiflis pouch'. There were no perioperative mortalities and only minor complication but abdominal wound dehiscence occurred with a subsequent hernia in 1 obese patient. One patient died of urethral recurrence and malignancy progression 14 months after surgery. During the follow-up period of 9-37 months, all renal units remained unobstructed. Eleven of 15 preoperatively dilated units improved. No case of pouch stone formation, stomal stenosis or difficulties with catheterization was observed. All patients are continent but 4 need catheterization at 3-hour intervals. The functional capacity is in the range of 310-560 ml. The Tiflis pouch is a capacious reservoir in which the continence state is satisfactory, perioperative complication rate is low and quality of life is high.