[Experiences with radical cystectomy combined with urinary diversion by ureteral sigmapouch (Mainz-pouch II) in bladder cancer patients].

INTRODUCTION

The tumour of the bladder is the third most frequent urological malignancy. Muscle invasive cancer can be cured by radical cystectomy. After removing the bladder; a sufficient urinary diversion should be performed.

AIM AND METHOD: The authors introduce the operative process of the pouch and their experiences with the procedure. The analysis of results were performed retrospectively.

RESULTS

Between 1998 and 2005 the authors performed radical cystectomy in 76 patients followed by: Mainz pouch II urinary diversion. The average age of the patients was 59.8 (20-78) years. The distribution by gender was: 58 male, 18 female patients. The average pathological T stage was 2.3; 22 patients (29%) had metastatic lymph nodes. 94% of the cases were transitional cell cancers, 3 (4%) of them had adenocarcinoma and one leiomyosarcoma. Reoperation was carried out in 7 cases (9.2%) because of wound healing defects, and one patient was reoperated because of bleeding and ileus respectively. Transitionally nephrostomy was performed in 5 cases (6.5%) because of upper urinary tract dilatation due to a stricture of ureter anastomosis. The average survival period was 24.4 (1-98) months.

CONCLUSION

Urinary diversion Mainz pouch II provides for safe, continent diversion requiring no urine bag; with an acceptable QL (quality of life). On the basis of the low number of complications and the acceptable QL; the authors consider this method as appropriate.