The continent ileal reservoir (kock pouch) for urinary diversion

Urinary diversion via a continent ileal reservoir was performed in 31 patients. The diversion was a primary procedure in 11 patients, while in 18 it was performed to convert an existing urinary diversion to a continent diversion. In two patients, malfunctioning cecocystoplasties were converted to continent ileum reservoirs. There were no operative mortalities and few early complications. Late complications causing malfunction of the nipple valves required revisional surgery in 15 patients. Postoperative follow-up presently is between 6 months and 10 years. Two patients have died: one in an accident and one of metastatic bladder carcinoma. The remaining 29 patients are continent and without reflux to the upper urinary tract. The reservoir is emptied by catheterization 4–5 times daily, not at night. The volume capacity of the reservoir is around 700 ml. One-third of our patients had constantly negative quantitative urine cultures, whereas two-thirds either had intermittent or constant bacteriuria. Dilatation of the upper urinary tract, progressive renal deterioration or metabolic disturbances have not been encountered. All patients are very satisfied with this type of urinary diversion.