THE KOCK POUCH URINARY RESERVOIR - 11/09/11

Doi : 10.1016/S0094-0143(05)70418-3

Peter T. Nieh, MD ^{^{*
From the Department of Urology, Lahey Hitchcock Medical Center, Burlington, Massachusetts}}

Résumé

Following Bricker's^{7Bricker E.M. Symposium on clinical surgery: Bladder substitution after pelvic evisceration Surg Clin North Am 1960 ; 30 : 1511

Cliquez ici pour aller à la section Références} description in 1950, the ileal conduit or loop rapidly displaced the ureterosigmoidostomy as the standard urinary diversion. The ease of construction, the mobility and reliable vascular arcades of the small bowel mesentery, relative paucity of early complications with the use of silicone stents, and fewer electrolyte disturbances are major advantages. Concerns with late upper tract damage from reflux and urinary infections, however, and stomal complications led to interest in nonrefluxing diversions with colon and ileocolonic segments, and eventually continent reservoirs. One of the earliest continent ileal reservoirs was advanced by Camey,^{7Camey M., LeDuc A. L'enterocystoplastie avec cystoprostatectomie totale pour cancer de la vessie Ann Urol 1979 ; 13 : 114

Cliquez ici pour aller à la section Références} whose procedure utilized a intact U-shaped segment of small bowel anastomosed to the membranous urethra at the apex. Camey's procedure, however, was troubled by nocturnal incontinence from the tubularized bowel contractions. The introduction of detubularization by using reconfigured bowel dramatically lowered intraluminal filling pressures and improved continence.^{20Kock N.G. The development of the continent ileal reservoir (Kock pouch) and application in patients requiring urinary diversion Bladder Reconstruction and Continent Urinary Diversion Chicago: Year Book Medical Publishers (1987).
269

Cliquez ici pour aller à la section Références, 23Kock N.G., Nilson A.E., Nilsson L.O., et al. Urinary diversion via a continent ileal reservoir: Clinical results in 12 patients J Urol 1982 ; 128 : 469

Cliquez ici pour aller à la section Références, 24Kock N.G., Nilson A.E., Norlen L., et al. Urinary diversion via a continent ileum reservoir: CLinical experience Scand J Urol Nephrol Suppl 1978 ; 49 : 23

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The Kock pouch, initially devised for continent ileostomy, was popularized in the early 1980s as a urinary reservoir by Skinner, who added several revisions to minimize complications associated with the antirefluxing, continent intussuscepted nipples.^{23Kock N.G., Nilson A.E., Nilsson L.O., et al. Urinary diversion via a continent ileal reservoir: Clinical results in 12 patients J Urol 1982 ; 128 : 469

Cliquez ici pour aller à la section Références, 34Skinner D.G., Boyd S.D., Lieskovsky G. Clinical experience with the Kock continent ileal reservoir for urinary diversion J Urol 1984 ; 132 : 1101

Cliquez ici pour aller à la section Références, 35Skinner D.G., Boyd S.D., Lieskovsky G., et al. Lower urinary tract reconstruction following cystectomy: Experience and results in 126 patients using the Kock ileal reservoir with bilateral ureteroileal urethrostomy J Urol 1991 ; 146 : 756

Cliquez ici pour aller à la section Références, 36Skinner D.G., Lieskovsky G., Boyd S. Continent urinary diversion J Urol 1989 ; 141 : 1323

Cliquez ici pour aller à la section Références, 37Skinner D.G., Lieskovsky G., Boyd S.D. Continuing experience with the continent ileal reservoir (Kock pouch) as an alternative to cutaneous urinary diversion: An update after 250 cases J Urol 1987 ; 137 : 1140

Cliquez ici pour aller à la section Références} The detubularized ileal reservoirs have lower-pressure contractions than detubularized large bowel reservoirs.^{6Boyd S.D., Everett R.W., Schiff W.M., et al. Treatment of unusual Kock pouch urinary calculi with extracorporeal shock wave lithotripsy J Urol 1988 ; 139 : 805

Cliquez ici pour aller à la section Références} Orthotopic placement of the neobladder to the urethral stump is preferable to a catheterizable cutaneous stoma. Neobladders were initially utilized in patients with no evidence of malignancy beyond the bladder neck, but recent experience with neobladders shows a decreased urethral recurrence rate in neobladder patients with prostatic urethral or stromal involvement compared with patients with a cutaneous stoma and defunctionalized urethra. Although this has been mostly limited to men, several recent studies have reported successful orthotopic neobladders in women by carefully preserving the external sphincter in the mid and distal urethra.^{40Stein J.P., Stenzl A., Esrig D., et al. Lower urinary tract reconstruction following cystectomy in women using the Kock ileal reservoir with bilateral ureteroileal urethrostomy: Initial clinical experience J Urol 1994 ; 152 : 1404

Cliquez ici pour aller à la section Références, 41Stenzl A., Colleselli K., Poisel S., et al. Rationale and technique of nerve sparing radical cystectomy before an orthotopic neobladder procedure in women J Urol 1995 ; 154 : 2044 [cross-ref]

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