Sigma-rectum pouch (Mainz pouch II).
2014
The Mainz pouch II is a well tolerated form of continent urinary diversion in
terms of morbidity, protection of the upper urinary tract and continence
rate, even in patients aged >65 years. Mainz pouch II was described by Fisch
and Hohenfellner in 1991. They viewed the simplicity and reproducibility of
the operation as one of its major advantages. A good continence rates between
93%-100% after this procedure has been shown in previous studies. The longer
follow up will show whether these high rates of continence can be maintained
with increasing age. The Mainz Pouch II serves as a satisfying continent
urinary diversion for both sexes in selected patients in terms of quality of
life. Evaluation of overall quality of life in patients with Mainz pouch II
urinary derivation has given encouraging results. Compliance and cooperation
of the patients, together with preoperative tests for anal competence, are
mandatory to avoid complications. The Mainz group reported that the overall
complication rate was low and comparable with other techniques of continent
urinary diversion. During the past years modifications of the original
technique have been described. These represent an increasing interest in the
procedure. Today, the techniques of low-pressure and reservoirs have
completely replaced classical ureterosigmoidostomy. In this review article
the main focus is aimed at history, complications, continence and quality of
life of patients with Mainz pouch II.
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