Long-term follow-up after ileocaecal continent cutaneous urinary diversion (Mainz I pouch): A retrospective study of a monocentric experience

Fahd Khalil; Saad Fellahi; Hicham Ouslim; Tarik Mhanna; Amine El Houmaidi; Mohammed Aynaou; Paapa Dua Boteng; Ali Barki; Yassine Nouini

doi:10.1016/j.aju.2015.09.004

Long-term follow-up after ileocaecal continent cutaneous urinary diversion (Mainz I pouch): A retrospective study of a monocentric experience

Arab J Urol. 2015 Dec;13(4):245-9. doi: 10.1016/j.aju.2015.09.004. Epub 2015 Oct 20.

Authors

Fahd Khalil¹, Saad Fellahi¹, Hicham Ouslim¹, Tarik Mhanna¹, Amine El Houmaidi¹, Mohammed Aynaou¹, Paapa Dua Boteng¹, Ali Barki¹, Yassine Nouini²

Affiliations

¹ Department of Urology, Mohammed VI University Hospital, Mohammed the First University, Oujda, Morocco.
² Urology A Department, Ibn-Sina University Hospital, Mohammed V University, Rabat, Morocco.

Abstract

Objective: To assess the long-term follow-up after ileocaecal continent cutaneous reservoir (ICCR) and to review the late complications.

Patients and methods: In all, 756 patients underwent an ICCR in our department, with long-term follow-up data available in 50 patients. The inclusion criterion was ICCR regardless of the indication and the exclusion criteria were orthotopic neobladder or other continent urinary diversions not performed with the ileocaecum. Patients were followed to record primary outcomes and late complications. Complications were stratified according to the Clavien-Dindo classification.

Results: The mean patient age was 44 years and pelvic malignancies were the first indication for urinary diversion. The mean (range) follow-up was 19 (9-36) years. A stoma stenosis was the most frequent outlet-related complication requiring re-intervention, followed by ischaemic outlet degeneration, and stoma incontinence. Six renal units (RUs) developed obstruction at the anastomotic site and were managed by open surgery. Three RUs had to be removed due to deterioration. A dederivation was necessary in three patients (6%).

Conclusion: The ICCR is a safe and established technique when an orthotopic pouch is impossible. The long-term follow-up shows acceptable complication rates and satisfactory continence conditions. However, large population studies are necessary to confirm this observation.

Keywords: Cutaneous ileocaecal pouch; ICCR, ileocaecal continent cutaneous reservoir; Long-term follow up; Mainz pouch; QoL, quality of life; RU, renal unit.