Chen K K, Chang L S, Chen M T
Department of Surgery, National Yang-Ming Medical College, Taipei, Taiwan, Republic of China.
J Urol. 1989 Jan;141(1):94-7. doi: 10.1016/s0022-5347(17)40602-1.
Urodynamic studies of the Kock pouch were conducted in 20 patients 3 to 36 months after radical cystectomy and urinary diversion for invasive bladder cancer. Functional pouch capacity, intrapouch pressure, maximal nipple pressure, maximal nipple closure pressure and functional nipple length with the pouch filled to capacity were measured. Intermittent involuntary pressure spikes resembling bowel peristaltic waves occurred in 5 patients (25 per cent). The mean functional pouch capacity was 280.0 +/- 119.2 ml. (standard deviation) and mean maximal intra-pouch pressure was 41.0 +/- 11.0 cm. water in patients with involuntary pressure spikes. In patients without involuntary pressure spikes these values were 332.7 +/- 114.5 ml. and 11.6 +/- 4.8 cm. water, respectively. For all patients the mean maximal nipple pressure was 72.1 +/- 24.6 cm. water, the mean maximal nipple closure pressure was 58.8 +/- 23.1 cm. water and the mean functional nipple length was 3.4 +/- 0.9 cm. A functional nipple length of less than or equal to 2.5 cm. and/or a low maximal nipple closure pressure (less than 40 cm. water) correlated with a small functional pouch capacity (less than 200 ml.) in 5 patients. Clinically, these 5 patients also required frequent catheterization to provide continence. A maximal nipple closure pressure greater than 60 cm. water and an adequate functional nipple length (greater than 3.0 cm.) correlated with a rather large functional pouch capacity (more than 350 ml.). The degree of continence provided by the Kock pouch appeared to be determined by functional nipple length, maximal nipple closure pressure, functional pouch capacity and maximal intrapouch pressure.
对20例因浸润性膀胱癌行根治性膀胱切除术及尿流改道术的患者，在术后3至36个月进行了Kock贮尿囊的尿动力学研究。测量了功能贮尿囊容量、囊内压力、最大乳头压力、最大乳头闭合压力以及贮尿囊充盈至容量时的功能乳头长度。5例患者（25%）出现了类似肠道蠕动波的间歇性非自主性压力峰值。出现非自主性压力峰值的患者，平均功能贮尿囊容量为280.0±119.2毫升（标准差），平均最大囊内压力为41.0±11.0厘米水柱。未出现非自主性压力峰值的患者，这些值分别为332.7±114.5毫升和11.6±4.8厘米水柱。所有患者的平均最大乳头压力为72.1±24.6厘米水柱，平均最大乳头闭合压力为58.8±23.1厘米水柱，平均功能乳头长度为3.4±0.9厘米。5例患者中，功能乳头长度小于或等于2.5厘米和/或最大乳头闭合压力低（小于40厘米水柱）与小的功能贮尿囊容量（小于200毫升）相关。临床上，这5例患者也需要频繁导尿以保持控尿。最大乳头闭合压力大于60厘米水柱且功能乳头长度足够（大于3.0厘米）与相当大的功能贮尿囊容量（大于350毫升）相关。Kock贮尿囊提供的控尿程度似乎由功能乳头长度、最大乳头闭合压力、功能贮尿囊容量和最大囊内压力决定。
