ABSTRACT
During 6 months period, a low pressure rectosigmoid reservoir for urine was created. This pouch [Mainz pouch II] obviates the need for colostomy, augmentation or extensive bowel surgery. Antimesenteric splitting of the rectosigmoid junction for 10-12 cm proximal and distal to this point and subsequent side to side anastomosis was performed. Urodynamic studies demonstrate that the detubularization is effective in rendering high pressure bowel contraction ineffective. The bowel was fixed at the promontory which lessens the risk of ureteral kinking and upper urinary tract dilatation. All the 18 patients that underwent this procedure were followed up for a period of 3-6 months. All patients except one were completely continent day and night. Only one female reported minimal soiling during night. The mean frequency was 5 times during day and 0-1 during night. The basal pressure within the sigma-rectum pouch at different filling volumes was 33 cm water. The low pressure improved continence, protected the upper urinary tract and even allowed dilated ureters to be implanted