Ghoneim M A, Kock N G, Lycke G, el-Din A B
Department of Urology, University of Mansoura, Egypt.
J Urol. 1987 Nov;138(5):1150-4. doi: 10.1016/s0022-5347(17)43531-2.
A modified Kock pouch was constructed in 16 patients with cancer of the bladder in whom cystoprostatectomy was indicated. Surgery entailed creation of a Kock pouch with 1 valve for prevention of reflux. The pouch then was anastomosed to the urethral stump. There was no operative mortality. Followup ranged between 3 and 9 months. Excretory urograms revealed excellent upper tract function and good evacuation of the pouch with minimal residual urine. Urodynamic studies demonstrated a volume capacity of greater than 300 ml., with pressures of less than 40 cm. water. All patients were continent during the day. Nocturnal enuresis was observed in 4 patients, 3 of whom responded favorably to I-desamino-8-D-arginine vasopressin therapy. The procedure is suitable whenever the urethra can be preserved after cystectomy for cancer.
对16例有膀胱前列腺切除术指征的膀胱癌患者构建了改良Kock袋。手术包括创建一个带1个瓣膜以防止反流的Kock袋。然后将该袋与尿道残端吻合。无手术死亡病例。随访时间为3至9个月。排泄性尿路造影显示上尿路功能良好，袋排空良好，残余尿量极少。尿动力学研究表明容量大于300毫升，压力小于40厘米水柱。所有患者白天均能自控排尿。4例患者出现夜间遗尿，其中3例对去氨基-8-D-精氨酸加压素治疗反应良好。只要在膀胱癌膀胱切除术后能保留尿道，该手术就是合适的。
