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Urodynamic and radiological assessments in sigmoidorectal (Mainz II) pouch for continent urinary diversion in Chinese patients after radical cystectomy

Purpose: To evaluate the pressure-volume changes and the radiological findings in Chinese patients undergoing sigmoidorectal pouch using sigmoidorectal pouch.

Methods: The ureters were implanted into the post walls of the detubularized sigmoid segment. Sigmoidal pressure and capacity and the anal pressure were measured. The intravenous pyelography, colon X-rays and uroflow rate assay were used. Continence was evaluated by interviewing the patients. A total of 20 patients with muscle-invasive bladder cancer underwent radical cystectomy and Mainz pouch II procedure between 2007 and 2012.

Results: In contrast to preoperative data, followed by postoperative procedure, the index has been changed significantly, such as colon X-rays anteroposterior pouch X-rays showed no passage up to an average volume of 360 ml (270-532 ml) through the descending colon, the sigmoidal colon pressure was on 26 cm H2O at the 3rd to the 6th month, but no changes in preoperative anal sphincter pressure.

Conclusion: Sigmoidorectal pouch could provide a reservoir with higher capacity and lower pressure without reflux to the upper urinary tract and descending colon, suggesting that Pouch II is a safe, effective and reproducible surgical means for urinary diversion in patients undergoing radical cystometry.

Author(s): Jingmin Yan, Bin Sun, Xianchu Li, Quan Hong, Guangxin Pan, Jizhou Shi, Heqing Guo