1988 Volume 79 Issue 9 Pages 1587-1591
Metal staples have been used for stabilization of an intussuscepted nipple valve in creation of a continent urinay reservoir (CUR) such as Kock pouch or Mainz pouch. We report successful stabilization of the intussuscepted nipple valve in creation of the ileal and colonic CURs without using metal staples which are expensive and may act as a nidus for stone formation. Our technique for stabilization of the nipple valve included complete mesenteric exclusion from the nipple valve, use of a Dacron mesh collar at the base of intussusception, and fixation of the nipple valve to the pouch wall by making a 2-3cm longitudinal full-layer incision through the outer layer of the nipple valve and the opposite pouch wall and sewing the edges of nipple valve incision to the edges of pouch wall incision. Using this technique the intussuscepted nipple valve was successfully stabilized without extussusception or prolapse for 6 to 20 months (average 12 months) of followup in 11 patients who underwent creation of the ileal or colonic CUR. All of these patients are continent day and night with easy intermittent self-catheterization.
