Modified ureterosigmoidostomy (Mainz Pouch II) in different age groups and with different techniques of ureteric implantation

In this section there are papers on three types of urinary diversion which are in common use. Authors from Germany, Greece and Turkey describe their experience with the Mainz pouch II, S-pouch neobladder and modified Hautmann bladder, respectively. OBJECTIVE To examine the outcome of Mainz Pouch II urinary diversion in different age groups and with different techniques of ureteric implantation. PATIENTS AND METHODS Between March 1995 and August 2002 a Mainz Pouch II was created in 41 patients (27 male and 14 female, median age 56.3 years, range 2–75) with 81 renal units (RU). For analysis, the patients were divided into 29 (70%) aged 65 years. Ureteric implantation with the Goodwin-Hohenfellner (GH) technique was used in 55 RU, with the Abol-Enein (AE) modification in 23 and Le-Duc procedure in three. The median (range) follow-up (available for 36 patients, 88%) was 19 (1–80) months. An unvalidated questionnaire was used to determine specific urinary diversion items. RESULTS Early complications occurred in 7% of patients, none requiring surgical intervention. Pyelonephritis occurred in five of 36 patients and seven of 71 RU (14% of the patients, 10% of the RU); all patients were 1 year, 8% required oral alkalinizing medication. CONCLUSION The Mainz Pouch II is a safe and reproducible urinary diversion, and serves as a satisfying alternative to other forms of continent urinary diversion in all age groups. The follow-up shows a low complication rate with good results in terms of continence. There were no significant differences in complication rates for the different ureteric implantation techniques. The long-term results remain to be evaluated.