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THE AUGMENTED RECTAL BLADDER FOR URINARY DIVERSION: EXPERIENCE WITH THE ORIGINAL VALVED RECTUM AND A VALVE‐LESS MODIFICATION
Author(s) -
Mikami Osamu,
Osazva Osamu,
Matsuda Tadashi,
Komatz Yosuke,
Takada Hideho,
Yoshioka Kazuhiko
Publication year - 1994
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.1994.tb00009.x
Subject(s) - medicine , rectum , urinary diversion , cystectomy , surgery , urinary system , stoma (medicine) , bladder cancer , urology , hydronephrosis , cancer
Kock's augmented and valved rectum was created in 10 patients following total cystectomy. During an observation period of up to 46 months, 4 patients died (1 from a recurrence of cancer, 1 from multiple organ failure subsequent to diabetes mellitus, 1 from coronary insufficiency, and 1 from cerebral hemorrhage). Post‐operative complications included valve failure in 1, hydronephrosis in 2, and mild nocturnal urinary incontinence in another. Hyperchloremic metabolic acidosis was particularly notable in the cases without an intussuceptive valve of the rectum. Their base excess ranged from ‐6.9 to ‐15.0 mM/l but the condition was satisfactorily controlled by oral administration of alkaline agents. Although the present method has a number of shortcomings, the absence of a stoma and elimination of the need for self‐catheterization are outstanding benefits. For these reasons, we believe that it is an effective option for urinary diversion.