Serous-lined, stapled pouch wall plication: initial results of a simple and quick novel continence mechanism in troubleshooting secondary to continent cutaneous urinary diversion

5 years ago

Serous-lined, stapled pouch wall plication: initial results of a simple and quick novel continence mechanism in troubleshooting secondary to continent cutaneous urinary diversion

Arkadius Kocot, Charis Kalogirou, Hubertus Riedmiller

Objectives To report a novel and straightforward technique of a secondary continent outlet for continent cutaneous urinary diversion (CCUD) reservoirs without the need for further bowel resection, reducing operation time and hospitalization. Patients And Methods From 2015 to 2017, 6 patients with unreconstructable, incontinent outlets (out of a total pool of n=595 CCUD patients) have undergone the technique described here at our department. It relies on the Mitrofanoff principle, using a stapled full-thickness pouch wall plication, which creates a flap-valve continence mechanism. Results All patients enjoyed full continence with ease of CIC in the postoperative period and on follow-up to a mean of 12,4 months (7-18 months). No major complications were encountered in all patients and the average capacity of the reservoirs was not compromised by the procedure (540 ml preoperatively vs. 500 ml in further follow-up). Conclusion In revisional surgery for secondary CCUD incontinence - especially if the patient has already lost a significant amount of bowel or has previously undergone radiation therapy – the technique described here represents a safe and effective alternative to restore continence. This article is protected by copyright. All rights reserved.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/bju.13979