Summary
Continence and a positive body image are important, especially to the adolescent patient. Since 1964 we have used ureterosigmoidostomy and have achieved a complete continence rate of 92.3%. The creation of a low-pressure reservoir by antimesenteric splitting of the recto-sigmoid eliminated many of the shortcomings of ureterosigmoidostomy. This procedure is termed the sigma-rectum pouch and has been applied in six children to date. Mainz-pouch bladder augmentation or substitution has been performed in 20 children, 17 of whom are completely continent. The results of the modified Young Dees procedure were disappointing. In three children, conversion into a continent diversion was necessary. All of the 41 children who underwent continent diversion using the Mainz pouch procedure are continent. The overall rate of late complications following the Mainz pouch procedure was 19.6%.
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References
Kock NG, Nilson AE, Nilsson LO, Norlen LJ, Philipson BM (1982) Urinary diversion via a continent ileal reservoir: clinical results in 12 patients. J Urol 128:469
Camey M (1987) Bladder replacement by ileocystoplasty following radical cystectomy. Semin Urol 5:8
Rowland RG, Mitchell ME, Bihrle R, Kahnoski RJ, Piser JE (1987) Indiana continent urinary reservoir. J Urol 137:1136
Thüroff JW, Alken P, Riedmiller H, Engelmann U, Jacobi GH, Hohenfellner R (1985) The Mainz pouch (mixed augmentation ileum and zecum) for bladder augmentation and continent urinary diversion. World J Urol 3:179
Duckett JW, Snyder HM III (1986) Continent urinary diversion: variations of the Mitrofanoff principle. J Urol 136:58
Mitrofanoff P (1980) Cystostomie continente transappendiculaire dans le traitement des vessies neurologiques. Chir Pediatr 21:297
Mesrobian HGJ, Kelalis PP, Kramer SA (1988) Long-term follow-up of 103 patients with bladder exstrophy. J Urol 139:719
Bennett AH (1973) Exstrophy of bladder treated by ureterosigmoidostomies: long-term evaluation. Urology 2:165
Spence HM, Hoffmann WW, Fosmire GP (1979) Tumor of the colon as a late complication of ureterosigmoidostomy for exstrophy of the bladder. Br J Urol 51:466
Warren RB, Warren TFCS, Hafez GR (1980) Late developments of colonic adenocarcinomas 49 years after ureterosigmoidostomy for exstrophy of the bladder. J Urol 124:550
Gittes RF (1986) Carcinogenesis in ureterosigmoidostomy. Urol Clin North Am 13:201
Stöckle M, Becht E, Voges G, Riedmiller H, Hohenfellner R (1990) Ureterosigmoidostomy: an outdated approach to bladder exstrophy? J Urol 143:770–775
Fisch M, Hohenfellner R (1991) Der Sigma Rektum Pouch: eine Modifikation der Harnleiterdarmimplantation. Aktuel Urol 22
Goodwin WE, Harris AP, Kaufman JJ, Beal JM (1953) Open, transcolonic ureterointestinal anastomosis: a new approach. Surg Gynecol Obset 97:295
Hohenfellner R, Planz C, Wulff H-D, Moormann G, Romahn A, Kunkel R, Oberhausen E, Burmeister W, Straub E (1967) Die transsigmoidale Ureterosimaoidostomie (Sigma-Rectum-Blase): Operationstechnik und Gesamtkörperkaliumbestimmung. Urologe 6:275
Gerhart JP (1990) Editorial. J Urol 143:774
Husmann DA, McLorie GA, Churchill BM (1989) Closure of the exstrophic bladder: an evaluation of the factors leading to its success and its importance on urinary continence. J Urol 142:522
Connor JP, Hensle TW, Lattimer JK, Burbidge KA (1989) Long-term follow-up of 207 patients with bladder exstrophy: an evolution in treatment. J Urol 142:793
Hollowell JG, Ransley PG (1991) Surgical management of incontinence in bladder exstrophy. Br J Urol 68:534
Marberger M, Straub E (1982) Ureterosigmoidostomy in children. In: Ashken MH (ed) Urinary diversion, ch. 3. Springer, New York Berlin Heidelberg, p 59
Mesrobian H-G, Kelalis PP, Kramer SA (1988) Long-term follow-up of 103 patients with bladder exstrophy. J Urol 139:719
Coffey RC (1929) Bilateral submucous transplantation of ureters into large intestine by the tube technique. JAMA 93:1929
Stamey TA (1956) The pathogenesis and implications of the electrolyte imbalance in ureterosigmoidostomy. Surg Gynecol Obstet 103:736
Bricker EM (1950) Bladder substitution after pelvic evisceration. Surg Clin North Am 30:1511
Johnson DE, Lamy SM (1977) Complications of a single-stage radical cystectomy and ileal conduit diversion: review of 214 cases. J Urol 117:171
Sullivan JW, Grabstald H, Whitmore WF Jr (1980) Complications of ureteroileal conduit with radical cystectomy: review of 336 cases. J Urol 124:797
Gonheim MA, Shebab-El-Din AB, Ashamallah AK, Gaballah MA (1981) Evolution of the rectal bladder as a method for urinary diversion. J Urol 126:737
Hinman F Jr (1988) Selection of intestinal segments for bladder substitution: physical and physiological characteristics. J Urol 139:519
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Fisch, M., Wammack, R., Sert, Ü. et al. Continent urinary diversion in childhood. World J Urol 10, 107–114 (1992). https://doi.org/10.1007/BF00183144
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DOI: https://doi.org/10.1007/BF00183144