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Orthotopic urinary diversion: the Kock ileal neobladder

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Summary

Orthotopic urinary diversion via the Kock ileal neobladder is the preferred form of bladder reconstruction in men and, now, in women undergoing cystectomy at the University of Southern California. Through June of 1993, 266 men were diverted in this fashion. There were 3 perioperative mortalities (1.1%); early complications occurred in 47 men (17.7%), whereas 35 (15.0%) experienced late complications. Approximately 85% of the men enjoy good or satisfactory continence day and night, with a large majority having a normal voiding pattern. Through May of 1993, 14 women were similarly diverted; 2 patients (14.2%) experienced early complications, whereas 1 patient (7.1%) had a late complication. The continence and voiding pattern appear to be even better in this small group of women as compared with the men. Orthotopic Kock continent urinary diversion yields an extraordinary functional result that can be accomplished with minimal complication and high patient satisfaction.

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References

  1. Ahlering TE, Lieskovsky G, Skinner DG (1984) Indications for urethrectomy in men undergoing single stage radical cystectomy for bladder cancer. J Urol 115:56–60

    Google Scholar 

  2. Bricker EM (1950) Bladder substitution after pelvic evisceration. Surg Clin North Am 30:1511–1521

    PubMed  Google Scholar 

  3. Camey M (1985) Bladder replacement by ileocystoplasty following radical cystectomy. World J Urol 3:161–165

    Google Scholar 

  4. Camey M, LeDuc A (1979) L'entero-cystoplastie avec cystoprostatectomie totale pour cancer de la vessie. Ann Urol (Paris) 13:114

    Google Scholar 

  5. Coffey RC (1930) Production of aseptic ureteroenterostomy by a suture transfixing the ureteral wall and the intestinal mucosa. JAMA 94:1748–1750

    Google Scholar 

  6. Colleselli K, Strasser H, Moriggl B, Stenzel A, Poisel S, Bartsch G (1994) Hemi-Kock to the female urethra: anatomical approach to the continence mechanism of the female urethra (abstract 1089). J Urol 151:500A

    Google Scholar 

  7. Frazier HA, Robertson JE, Paulson DF (1992) Complications of radical cystectomy and urinary diversion: a retrospective review of 675 cases in 2 decades. J Urol 148:1401–1405

    PubMed  Google Scholar 

  8. Gilchrist RK, Merricks JW, Hamlin HH, Rieger IT (1950) Construction of a substitute bladder and urethra. Surg Gynecol Obstet 90:752–760

    PubMed  Google Scholar 

  9. 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 128:469–475

    PubMed  Google Scholar 

  10. Light JK, Scardino PT (1986) Radical cystectomy with preservation of sexual and urinary function. Use of ileocolonic pouch (“Le Bag”). Urol Clin North Am 13:261–269

    PubMed  Google Scholar 

  11. Raz S, McLorie G, Johnson S, Skinner DG (1978) Management of the urethra in patients undergoing radical cystectomy for bladder carcinoma. J Urol 120:298–300

    PubMed  Google Scholar 

  12. Richie JP, Skinner DG (1978) Carcinoma in situ of the urethra associated with bladder carcinoma: the role of urethrectomy. J Urol 119:80–81

    PubMed  Google Scholar 

  13. Thrüoff JW, Alken P, Riedmiller H, Jacobi GH, Hohenfellner R (1988) 100 cases of Mainz-pouch: continuing experience and evolution. J Urol 140:283–288

    PubMed  Google Scholar 

  14. Rowland RG, Mitchell ME, Bihrle R, Kanhosky RJ, Piser JF (1987) Indiana continent urinary reservoir. J Urol 137:1136–1139

    PubMed  Google Scholar 

  15. Skinner DG, Lieskovsky G (1984) Contempory cystectomy with pelvic node dissection compared to preoperative radiation therapy plus cystectomy in management of invasive bladder cancer. J Urol 131:1069–1072

    Google Scholar 

  16. Skinner DG, Lieskovsky G (1988) Technique of radical cystectomy. In: Skinner DG, Lieskovsky G (eds) Diagnosis and management of genitourinary cancer. W. B. Sanders, Philadelphia, pp 607–621

    Google Scholar 

  17. Skinner DG, Crawford ED, Kaufman JJ (1980) Complications of radical cystectomy for carcinoma of the bladder. J Urol 123:640–642

    PubMed  Google Scholar 

  18. Skinner DG, Lieskovsky G, Boyd SD (1989) Continent urinary diversion. J Urol 141:1323–1327

    PubMed  Google Scholar 

  19. Skinner DG, Boyd SD, Lieskovsky G, Bennett C, Hopwood B (1991) Lower urinary tract reconstruction following cystectomy: experience and results in 126 patients using the Kock ileal reservoir with bilateral ureteroileal urethrostomy. J Urol 146:756–760

    PubMed  Google Scholar 

  20. Stein JP, Stenzl A, Esrig D, Freeman JA, Boyd SD, Lieskovsky G, Cote RJ, Bennett C, Colleselli K, Draxl H, Janetschek G, Poisel S, Bartsch G, Skinner DG (1994) Lower urinary tract reconstruction following cystectomy in women using the Kock ileal reservoir with bilateral ureteroileal urethrostomy: initial clinical experience. J Urol 152:1404–1408

    PubMed  Google Scholar 

  21. Stein JP, Cote RJ, Freeman JA, Esrig D, Elmajian DA, Groshen S, Skinner EC, Boyd SD, Lieskovsky G, Skinner DG (1995) Indications for lower urinary tract reconstruction in women after cystectomy for bladder cancer: a pathological review of female cystectomy specimens. J Urol 154:1329–1333

    PubMed  Google Scholar 

  22. Stöckle M, Gökcebay E, Riedmiller H, Hohenfellner R (1990) Urethral tumor recurrences after radical cystoprostatectomy: the case for primary cystourethroprostatectomy? J Urol 143:41–43

    PubMed  Google Scholar 

  23. Tarter TH, Freeman JA, Chen S, Esrig D, Elmajian DA, Stein JP, Groshen S, Lieskovsky G, Skinner DG (1995) Urethral recurrence in patients with ileal neobladders (abstract 342). J Urol 153:314A

    Google Scholar 

  24. Walsh PC, Donker PJ (1982) Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 128:492–497

    PubMed  Google Scholar 

  25. Walsh PC, Quinlan DM, Morten RA, Steiner MS (1990) Radical retropubic prostatectomy. Improved anastomosis and urinary continence. Urol Clin North Am 17:679–684

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, University of Southern California, Los Angeles, California, USA

    D. A. Elmajian (Fellow Genitourinary Oncology), J. P. Stein & D. G. Skinner

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  1. D. A. Elmajian
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  2. J. P. Stein
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  3. D. G. Skinner
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Elmajian, D.A., Stein, J.P. & Skinner, D.G. Orthotopic urinary diversion: the Kock ileal neobladder. World J Urol 14, 40–46 (1996). https://doi.org/10.1007/BF01836343

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