Fisch M, Wammack R, Müller S C, Hohenfellner R
Department of Urology, University of Mainz School of Medicine, FRG.
Eur Urol. 1994;25(1):7-15. doi: 10.1159/000475238.
The Mainz pouch II procedure has proved to be a substantial modification of the classical technique of ureterosigmoidostomy at many institutions. To date we have used this procedure in 72 patients, including 15 children. Detubularization causes a low pressure and eliminates high-pressure contractions. Without the risk of compromising the blood supply the pouch is fixed at the promontory which reduces the risk of ureteral kinking and upper urinary tract dilatation as it is sometimes observed after ureterosigmoidostomy. The technique is not only indicated in cases of failed ureterosigmoidostomy but also for primary urinary diversion. Of the 72 patients operated, all are evaluable with a follow-up of 1-31 months. All patients are continent during the daytime with a mean emptying frequency of 5. All but one elderly woman are dry at night with a mean frequency of 1. The described urodynamic/rectodynamic evaluation enables a reliable prediction of postoperative continence. With the reservoir full the basal pressure was 24 cm H2O and the highest peak pressure recorded was 35 cm H2O.
在许多机构中，美因茨Ⅱ型储袋手术已被证明是对经典输尿管乙状结肠吻合术的重大改进。迄今为止，我们已对72例患者实施了该手术，其中包括15名儿童。去管化可形成低压并消除高压收缩。在不影响血供的情况下，将储袋固定于岬部，这降低了输尿管扭结和上尿路扩张的风险，而输尿管乙状结肠吻合术后有时会出现这种情况。该技术不仅适用于输尿管乙状结肠吻合术失败的病例，也适用于原发性尿流改道。在接受手术的72例患者中，所有患者均在1至31个月的随访期内可进行评估。所有患者白天均能自主控制排尿，平均排空频率为5次。除一名老年女性外，所有患者夜间均无遗尿，平均频率为1次。所描述的尿动力学/直肠动力学评估能够可靠地预测术后控尿情况。储袋充盈时，基础压力为24 cm H₂O，记录到的最高峰值压力为35 cm H₂O。
