Nitkunan, T; Leaver, R; Patel, HRH; Woodhouse, CRJ; (2004) Modified ureterosigmoidostomy (Mainz II): a long-term follow-up. BJU INT , 93 (7) 1043 - 1047. 10.1111/j.1464-410X.2004.04778.x.
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OBJECTIVETo assess the long-term results in patients treated using a modified ureterosigmoidostomy (Mainz II).PATIENTS AND METHODSBetween 1994 and 1999, 17 patients had their lower urinary tract reconstructed by a ureterosigmoidostomy, modified by reconfiguring the rectum to make a low-pressure reservoir (Mainz II). All patients were followed on a standard protocol. Data were extracted from the database and from a review of the case-notes. In 12 patients the procedure was with a radical cystectomy for carcinoma. Five had a failed conventional ureterosigmoidostomy for bladder exstrophy and therefore proceeded to a Mainz II. The data on continence and complications were retrieved for a retrospective analysis; the mean (range) follow-up was 6.4 (4-8.6) years.RESULTSTen of those with bladder cancer and one in the revision group were continent. Two patients in the revision group had sufficiently severe nocturnal incontinence to require conversion to a colonic conduit. Seven of the 17 patients had hyperchloraemic acidosis, one had pyelonephritis and one had renal stones. There were no anastomotic neoplasms.CONCLUSIONThe Mainz II has a good outcome if used as the primary procedure. In patients with an existing ureterosigmoidostomy who are incontinent, detubularization of the rectosigmoid alone is unlikely to restore continence.
|Title:||Modified ureterosigmoidostomy (Mainz II): a long-term follow-up|
|Keywords:||bladder cancer, exstrophy, ureterosigmoidostomy, Mainz II, urinary diversion, CONTINENT URINARY-DIVERSION, SIGMA RECTUM POUCH, MITROFANOFF PRINCIPLE, EXPERIENCE, EXSTROPHY, COMPLICATIONS, CYSTECTOMY, BLADDER|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of) > Research Department of General Surgery|
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of) > Research Department of Urology
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