Functional Characteristics of Kock Continent Ileal Reservoir

Lee, Eun Sik; Ahn, Han Jong; Lee, Chong Koo; Lee, Sang Eun; Lee, Chong Wook

Abstract

The functional characteristics of Kock continent ileal reservoir were studied in 25 patients who underwent continent ileal reservoir at Seoul National University Hospital from Jan. 1987. Among them 23 patients underwent simultaneous total cystectomy and this procedure for bladder tumor, 2 patients a reservoir procedure only for a neurogenic bladder or urethral stricture. The operating procedure was carried out according to Skinner modification of Kock method initially and according to our minor modification subsequently. The catheterization mode, urine culture, volume and pressure of reservoir were checked by every 3 months. Fluoroscopic examination of reservoir was carried at 3. 6 and 12 months of follow-up. The capacity of reservoir was 200ml just postoperatively, Which increased to 450ml at 3 months, to 750ml at 6 months but did not increased thereafter. Low reservoir pressure without involuntary spike was recognized in most patients except in 2 patients where involuntary spike above 20 cmH20 were noticed in cystometry, but it did not related to incontinence. There were no reflux or true incontinence in followup period by fluoroscopic examination, but in 2 patients partial incontinence occurred when urine volume exceeded 200ml. Various microorganisms were grown in 80% or patients but there were no clinical symptoms. The results indicate that the continent ileal reservoir provide a urine storage function with adequate capacity and without reflux and incontinence. Most patients appreciate better quality of life by not having collecting device.