Seven years experience with kock continent ileal reservoir and urethral kock bladder replacement

ABSTRACT

From May 1983 to June 1990, the Kock pouch was used for continent urinary diversion in 35 patients and the urethral Kock in 29. The indications were variable. No operative mortality was encountered, but 5 patients [7.8%] died from malignancy related causes and 2 older patients [3.12%] developed local pelvic recurrence during the first year. The mean follow-up period was 2.5 years. Early complications encountered in the two groups were not amazing and only 2 patients [one in each group] required intervention. Overall late complication rate that necessitated reoperation was [31.5%], being 34.5% among patients with Kock pouch and 20% among those with urethral Kock. Ultimate continence following Kock pouch was seen in 93%, while all the patients submitted to urethral Kock operation achieved diurnal continence with partial and infrequent enuresis in 16% within 6 months the mean capacity of the mature urethral Kock pouches and Kock reservoirs reached 650 ml and 590 ml, respectively. The average basal pressure in both groups was 4 cm H2O and the pressure at maximum capacity was almost always around 30 cm H2O. Stones in the pouchs were generally frequent [19.97%] and also was the stricture urethral in the urethral Kock group [12%]