Summary
The Indiana pouch was developed as a modification of the Glichrist procedure in 1984. The need for full detubularization of the reservoir was recognized early and was achieved by an ileal patch on the cecal reservoir or by an antimesenteric incision of the cecal segment with folding and transverse closure, the efferent limb and continence mechanism were modified to promote ease of catheterization and improved continence. These modifications gave markedly better results with lower reoperation rates. A group of 81 patients with a minimum of 2 years of follow-up are reported herein. The most recent modification uses absorbable GIA and TA55 staples to detubularize and close the reservoir. This stapling technique has been employed in 20 patients and has resulted in decreased operating times without any significant increase in complications. In its current form, the Indiana pouch meets all the criteria for a satisfactory continent cutaneous reservoir and has a favorable reoperation rate as compared with other pouches.
Similar content being viewed by others
References
Bejany DE, Politano VA (1988) Stapled and nonstapled tapered distal ileum for construction of a continent colonic urinary reservoir. J Urol 140:491
Gilchrist RK, Merricks JW, Hamlin HH, Rieger IT (1950) Construction of a substitute bladder and urethra. Surg Gynecol Obstet 90:752
Hinman F, Weyrauch HM Jr (1936) A critical study of the different principles of surgery which have been used in ureterointestinal implantation. Trans Am Assoc Genitourin Surg 29:15
Rowland RG (1995) Complications of continent cutaneous reservoirs and neobladders — series using contemporary techniques. AUA Update Ser 14/25:202–208
Rowland RG (1995) Continent cutaneous urinary diversion: the Indiana pouch. In: Vogelzang NJ, Shipley WU, Scardino PT (eds) Comprehensive textbook of genitourinary oncology. Williams and Wilkens, Baltimore (in press)
Rowland RG, Kropp BP (1994) Evolution of the Indiana continent urinary reservoir. J Urol 152:2247
Rowland RG, Mitchell ME, Bihrle R (1985) The ileocecal continent urinary reservoir. World J Urol 3:185
Rowland RG, Mitchell ME, Bihrle R, et al (1987) Indiana continent urinary reservoir. J Urol 137:1136
Rowland RG, Bihrle R, Scheidler D (1991) Update on the Indiana continent urinary reservoir. Probl Urol 5:269
Simon J (1852) Ectopic vesicle (absence of the anterior walls of the bladder and pubic abdominal parietes), operation for directing the orifices of the ureter into the rectum, temporary success, subsequent death, autopsy. Lancet II:568
Verhoogen J, DeGraeurve A (1908) La cystectomie totale. Folia Urol 3:629
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Rowland, R.G. Present experience with the Indiana pouch. World J Urol 14, 92–98 (1996). https://doi.org/10.1007/BF00182564
Issue Date:
DOI: https://doi.org/10.1007/BF00182564