Results of mainz-pouch II transrectal urinary diversion from a single center

Authors

DOI:

https://doi.org/10.26641/2307-5279.24.2.2020.208725

Keywords:

transrectal urinary diversion, Mainz-pouch II

Abstract

Aim. Evaluation of results of Mainz-pouch II surgery (MP II) after cystectomy in patients with bladder cancer and controlled urinary diversion. Materials and methods. Clinical records of 118 patients with invasive bladder cancer were analyzed. The patients were evaluated before surgery under a standardized diagnostic protocol, also urinary continence duration was evaluated with an anal sphincter as one of the potential contraindications to surgery. Results. Intraoperative complications during MP II occurred in 6 (5%) patients. 29 (24.5%) patients showed complications in the early postoperative period, associated with impaired kidney function, urinary tract infections, anastomotic leak. Late postoperative complications were revealed in 71 (75.5%) patients, resulted in metabolic acidosis 37 (39.3%) and upper urinary tract infection exacerbations as follows: 13 cases of ureteroenteric anastomosis stenosis (13.9%) and 18 of ureteroenteric gas reflux (19.1%). Night incontinence was observed in 3 (3.1%) patients. The average urination frequency during the day and night was 5.1 + 1.1 and 2.0 + 0.5 times, respectively. Conclusion. The MP II procedure involves a low pressure reservoir, even at large volumes of filling, and the detubularized and reconfigured intestine walls have no coordinated contractions, reducing frequency of ureteroenteric reflux into the kidneys. The main disadvantage of MP II surgery is metabolic acidosis, which may be compensated under outpatient conditions.

References

Simon J. Ectopia vesicae (absence of the anterior walls of the bladder and pubis abdominal parietes); operation for directing the orifices of the uterus into the rectum; temporary success; subsequent death; autopsy. Lancet. 1892. No. 2. P. 568–570.

Hinman F., Weyrauch H.M.Jr. A critical study of the different principles of surgery which have been used in uretero-intestinal implantation. Trans Am Assoc Genitourin Surg. 1936. No. 29. P. 15–16.

Stamey T.A. The pathogenesis and implications( of the electrolyte imbalance in ureterosigmoidostomy. Surg Gynecol Obstet. 1956. No. 103. P. 736–758.

Fisch M., Wammack R., Muller S.C., Hohenfellner R. The Mainz pouch II (sigma rectum pouch). J Urol. 1993. No. 149. P. 258–263.

Gerharz E.W., Kuhl U.N., Weingartner K. et al. Experience with the Mainz modification of ureterosigmoidostomy. Br J Surg. 1998. No. 85. P. 1512–1516.

Woodhouse C.R.J., Christofides M. Modified ureterosigmoidostomy (Mainz II) – technique and early results. Br J Urol. 1998. No. 81. P. 247–252.

Lee R.K., Abol-Enein H., Artibani W., Bochner B., Dalbagni G., Daneshmand S., Fradet Y., Hautmann R.E., Lee C.T., Lerner S.P. et al. Urinary diversion after radical cystectomy for bladder cancer: Options, patient selection, and outcomes. BJU Int. 2014. No. 113. P. 11–23.

Fisch M., Wammack R., Muller S.C., Hohenfellner R. The sigma rectum pouch (Mainz pouch II). World. J. Urol. 1996. No. 14. P. 68–72.

Fisch M., Wammack R., Muller S.C., Hohenfellner R. The Mainz pouch II. Eur. Urol. 1994. No. 25. P. 7–15.

Fisch M., Wammack R., Steinbach F., Muller S.C., Hohenfellner R. Sigma-rectum pouch (Mainz pouch II). Urol. Clin. North Am. 1993. No. 20. P. 561–569.

Le Duc A., Camey M., Teillac P. An original antireflux ureteroileal implantation technique: long term follow-up. J Urol. 1987. No. 137. P. 1156–1158.

Kock N.G., Ghoneim M.A., Lycke K.G., Mahran M.R. Urinary diversion to the augmented and valved rectum: Preliminary results with a novel surgical procedure. J Urol. 1988. No. 140. P. 1375–1379.

Ghoneim M.A., Shehab El-Din A.B., Ashamallah A.K., Gaballah M.A. Evolution of the rectal bladder as a method for urinary diversion. J Urol. 1981. No. 126. P. 737–740.

Gilja I., Kovacic M., Radej M., Kosuta D., Bakula B., Goles L. The sigmoidorectal pouch (Mainz pouch II). Eur. Urol. 1996. No. 29. P. 210–215.

Chang S.S., Cookson M.S., Baumgartner R.G., Wells N., Smith J.A. Analysis of early complications after radical cystectomy: results of a collaborative care pathway. J Urol. 2002. No. 167. P. 2012–2016.

Obek C., Kural A.R., Ataus S. et al. Complications of the Mainz Pouch II (sigma rectum pouch). Eur Urol. 2001. No. 39. P. 204–211.

Hadzi-Djokic J.B., Basic D.T. A modified sigma-rectum pouch (Mainz pouch II) technique: analysis of outcomes and complications on 220 patients. BJU. 2006. No. 97. P. 587–591.

Ferris O.D., Odel H.M. Electrolyte pattern of the blood after bilateral ureterosigmoidostomy. JAMA. 1950. No. 142. P. 634–641.

Stamey T.A. The pathogenesis and implications of the electrolyte imbalance in ureterosigmoidostomy. Surg Gynecol Obstet. 1956. No. 103. P. 736–758.

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Published

2020-07-27

Issue

Vol. 24 No. 2 (2020)

Section

Oncourology

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