The sigma rectum pouch (Mainz pouch II)

Fisch, Margit; Wammack, R.; Hohenfellner, R

doi:10.1007/bf00182560

Cited by 50 publications

(48 citation statements)

References 22 publications

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“…We regularly monitor the acid/base balance; at a base excess of <− 2.5 mmol/L we give oral alkalinizing agents such as potassium/sodium citrate. The proportion of patients who require alkalizing agents is 70% in those with a Mainz pouch II [12]. Early medical intervention for balancing a base deficit prevents clinical metabolic acidosis.…”

Section: Discussionmentioning

confidence: 99%

“…Their mean (range) age at primary conduit diversion was 5.5 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) years, the mean interval between conduit diversion and conversion into continent anal diversion 8 (4-18) years and the mean age at conversion into a Mainz pouch II was 13 (8-32) years. The characteristics of the patients are summarized in Table 1.…”

Section: Methodsmentioning

confidence: 99%

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Conversion from colonic conduit into recto‐sigmoid pouch (Mainz pouch II)

Pahernik¹,

Wiesner²,

Gillitzer³

et al. 2005

BJU International

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The Mainz Pouch II has now been used widely and found to be a valuable addition to the various types of urinary diversion. The authors from Mainz describe how a colonic conduit can be converted into a Mainz Pouch II, and the expected outcome from such a procedure. OBJECTIVE To report our long‐term results of conversion from conduit conversion into a continent anal urinary diversion, as after conduit urinary diversion in childhood, some patients wish to have a later conversion to a continent diversion to avoid external appliances and to improve their quality of life. PATIENTS AND METHODS Between 1992 and 2003, 139 patients had a urinary diversion with a recto‐sigmoid pouch (Mainz pouch II), of whom four had a conversion from a colonic conduit diversion to a recto‐sigmoid pouch. The mean (range) age at conduit diversion was 5.5 (3–14) years and the mean interval between conduit diversion and conversion to a continent anal diversion was 8 (4–18) years. The mean age at conversion into a Mainz pouch II was 13 (8–32) years and the follow‐up afterward was 11.5 (1–13) years. The conversion was done by incorporating the pre‐existing colonic conduit into the recto‐sigmoid pouch with no ureteric reimplantation. RESULTS There were no early complications; one nephrectomy was required 5 years after conversion because of uretero‐intestinal obstruction and pyelonephritis. All other reno‐ureteric units remained stable and renal function was maintained. All patients are continent day and night; three require substitution with alkali at a base excess of < −2.5 mmol/L to prevent hyperchloraemia and acidosis. CONCLUSION The recto‐sigmoid pouch is a therapeutic option when patients desire conversion from an incontinent type of urinary diversion to a continent type.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Conversion from colonic conduit into recto‐sigmoid pouch (Mainz pouch II)

Pahernik¹,

Wiesner²,

Gillitzer³

et al. 2005

BJU International

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“…Current knowledge and the techniques of urinary diversion may obviate the drawbacks of ureterosigmoidostomy and free the patients from stomal problems. Such an idea has led to trials with ileocecal ureterosigmoidostomy, 19 the augmented and valved rectum, 20 the sigma rectum pouch, 21 and IRB by us. 3 This survey was a retrospective and non-randomized study.…”

Section: Discussionmentioning

confidence: 99%

Editorial Comment

Gotoh¹

2002

Int J of Urology

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Background : The ileocecal rectal bladder (IRB) after cystectomy has been devised, in which continence is controlled by the anal sphincter. To assess how this procedure influences postoperative health-related quality of life (QOL), IRB patients were compared with ileal conduit (IC) patients using a questionnaire mail-out. Methods : The questionnaire consisted of 35 questions. The questions were multiple choice and the answers were rated on a Linkert rank-type four-point scale. The IRB operation was performed on 29 patients between March 1990 and July 1998. The questionnaire was mailed to 21 of 29 IRB and 34 IC patients, who underwent either operation during the same period and had no persistent or recurrent tumor. Statistical analysis was performed by Mann-Whitney U -test. Results : All 21 IRB patients (100%) and 24 IC patients (71%) responded to the questionnaire. The mean age and follow-up time of both groups were not significantly different. The IRB group had better scores in many items, especially, in those of self-care, turning over freely during sleep, and tension. However, 43% of IRB patients used pads for small amounts of incontinence (spotting) and worried about flatus. Conclusion : These findings show that many functional and symptomatic health-related QOL sores are better after IRB and support the use of this procedure of urinary diversion for selected patients.

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“…Die Mainzer Klinik (Fisch/Hohenfellner) inaugurierte das Adaptieren von 2 Sigmaschlingen mit antimesenterialer Eröffnung, angelehnt an die kutanen Reservoire und die Implantation der Ureteren in das somit gestaltete Niederdruckreservoir (⊡ Abb. 11) [3,4]. Die Stuhlkontinuität wurde gewahrt, und das Stuhl-Urin Gemisch kann sich in einem Sigmapouch sammeln.…”

Section: Rektosigmoidpouch (Mainz-pouch Ii)unclassified

Harnableitung nach Zystektomie

Albers

2004

Urologe [A]

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Urinary diversions become necessary in cases of a tumor-bearing urinary bladder requiring cystectomy or a nonfunctioning urinary bladder, e.g., due to neurogenic disorders. In order to choose the ideal urinary diversion, long-term function as well as complication rates, quality of life issues, and patient's acceptance become matters of debate. In this regard, orthotopic diversions are usually the first choice. However, there are contraindications for an orthotopic bladder substitute and sometimes the decision has to be made intraoperatively. Therefore, urinary diversions should only be offered by uro-oncological centers that are capable of performing different kinds of diversions. For many decades incontinent diversions have been the standard of care and for 20 years different kinds of cutaneous and orthotopic continent reservoirs have been performed. Bladder substitutes by means of tissue engineering, however, are still experimental.

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The sigma rectum pouch (Mainz pouch II)

Cited by 50 publications

References 22 publications

Conversion from colonic conduit into recto‐sigmoid pouch (Mainz pouch II)

Conversion from colonic conduit into recto‐sigmoid pouch (Mainz pouch II)

Editorial Comment

Harnableitung nach Zystektomie

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