Kock Continent Ileal Reservoir

Park, Young Kyung

Abstract

From January 1985 through July 1986, 5 patients with bladder cancer underwent urinary diversion that included creation of a continent reservoir from an ileal segment, according to the method described originally by Kock in a case and modified by Skinner in 4 cases. An important modification included isolation of a narrow strip of mesentery for 6-8cm along the efferent and afferent limbs of the pouch to allow adequate ileal intussusception and fixation to prevent reflux and to ensure continence. Patients perform self-catheterization ever 4 to 6 hours during the day and once at night. Renal functions are normal limit, but hyperchloremia encountered in all patients. Retrograde reservoir grams have demonstrated no reflux in all cases and excretory urograms have demonstrated normal upper urinary tract in 4 patients and mild hydronephrosis in a patient. All patients are satisfied with this type of urinary diversion.