The Mainz Pouch II

Fisch, Margit; Wammack, R.; Müller, S. C.; Hohenfellner, R

doi:10.1159/000475238

Cited by 26 publications

(29 citation statements)

References 4 publications

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“…In the present cases treatment with balloon dilatation was insufficient. If scarring and fibrosis have started, ureteric neo-implantation is inevitable [9]. This was true in the present cases and confirmed by histological examination.…”

Section: Discussionsupporting

confidence: 83%

“…In comparison with other series [5,9,12] there was no serious acidosis in the present study, while others reported a need for alkalinizing agents in 51-65% of patients [4,9,10,12]. Pajor and Keleman [23] reported a need for oral medication in all their patients.…”

Section: Discussioncontrasting

confidence: 43%

“…The rate of pyelonephritis was 7% in RU implanted with the GH technique and 1% with the AE and Le Duc, respectively. Other series showed similar results of 0-6% [7,[9][10][11][12]. Pyelonephritis only occurred in younger patients, suggesting that there is good protection of the upper urinary tract in elderly patients.…”

Section: Discussionmentioning

confidence: 59%

“…A modification of the technique using sigma detubularization [4] improved the continence rate and the so-called Mainz Pouch II procedure became an alternative technique of urinary diversion [4][5][6]. Ongoing problems include ureteric stenosis at the ureterosigmoidal junction [7][8][9], the need for oral akalinizing agents [4,5,8,[10][11][12] and the development of secondary malignancies at the ureteric implantation site [13]. It remains unclear whether decreasing anal sphincter function in elderly patients influences the continence rate in Mainz Pouch II urinary diversion.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Modified ureterosigmoidostomy (Mainz Pouch II) in different age groups and with different techniques of ureteric implantation

et al. 2004

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OBJECTIVETo examine the outcome of Mainz Pouch II urinary diversion in different age groups and with different techniques of ureteric implantation. PATIENTS AND METHODSBetween March 1995 and August 2002 a Mainz Pouch II was created in 41 patients (27 male and 14 female, median age 56.3 years, range 2-75) with 81 renal units (RU). For analysis, the patients were divided into 29 (70%) aged < 65 years and 12 (30%) aged > 65 years. Ureteric implantation with the Goodwin-Hohenfellner (GH) technique was used in 55 RU, with the Abol-Enein (AE) modification in 23 and Le-Duc procedure in three. The median (range) follow-up (available for 36 patients, 88%) was 19 (1-80) months. An unvalidated questionnaire was used to determine specific urinary diversion items. RESULTSEarly complications occurred in 7% of patients, none requiring surgical intervention. Pyelonephritis occurred in five of 36 patients and seven of 71 RU (14% of the patients, 10% of the RU); all patients were < 65 years old. In five of seven RU pyelonephritis was caused by the development of upper urinary tract dilatation; none required surgical revision. Ureteric stenosis requiring reimplantation occurred in two RU (2%, one GH, one AE). All patients were continent in the daytime; all but one patient had to wake to urinate at night, with 36% having to do so more than six times. Of the patients, 63% were able to distinguish between stool and urine. Initially, alkalinizing drugs to prevent metabolic acidosis were taken by 30% of the patients. Of previously medicated patients with a follow-up of > 1 year, 8% required oral alkalinizing medication. CONCLUSIONThe Mainz Pouch II is a safe and reproducible urinary diversion, and serves as a satisfying alternative to other forms of continent urinary diversion in all age groups. The follow-up shows a low complication rate with good results in terms of continence. There were no significant differences in complication rates for the different ureteric implantation techniques. The long-term results remain to be evaluated.

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