Modified ureterosigmoidostomy (Mainz II): a long-term follow-up
Article first published online: 5 MAY 2004
Volume 93, Issue 7, pages 1043–1047, May 2004
How to Cite
Nitkunan, T., Leaver, R., Patel, H.R.H. and Woodhouse, C.R.J. (2004), Modified ureterosigmoidostomy (Mainz II): a long-term follow-up. BJU International, 93: 1043–1047. doi: 10.1111/j.1464-410X.2004.04778.x
- Issue published online: 5 MAY 2004
- Article first published online: 5 MAY 2004
- Accepted for publication 14 January 2004
- bladder cancer;
- Mainz II;
- urinary diversion
To assess the long-term results in patients treated using a modified ureterosigmoidostomy (Mainz II).
PATIENTS AND METHODS
Between 1994 and 1999, 17 patients had their lower urinary tract reconstructed by a ureterosigmoidostomy, modified by reconfiguring the rectum to make a low-pressure reservoir (Mainz II). All patients were followed on a standard protocol. Data were extracted from the database and from a review of the case-notes. In 12 patients the procedure was with a radical cystectomy for carcinoma. Five had a failed conventional ureterosigmoidostomy for bladder exstrophy and therefore proceeded to a Mainz II. The data on continence and complications were retrieved for a retrospective analysis; the mean (range) follow-up was 6.4 (4–8.6) years.
Ten of those with bladder cancer and one in the revision group were continent. Two patients in the revision group had sufficiently severe nocturnal incontinence to require conversion to a colonic conduit. Seven of the 17 patients had hyperchloraemic acidosis, one had pyelonephritis and one had renal stones. There were no anastomotic neoplasms.
The Mainz II has a good outcome if used as the primary procedure. In patients with an existing ureterosigmoidostomy who are incontinent, detubularization of the rectosigmoid alone is unlikely to restore continence.