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RESEARCH PRODUCT

Applications of Ureterosigmoidostomy in Bladder Exstrophy

subject

description

Until 1994, 95 patients with bladder exstrophy and 20 with incontinent epispadias were operated upon at our department. During the last years more and more exstrophycripples were referred to our institution after primary treatment elsewhere. Thus a total of 56 of the 104 patients had a secondary treatment after failure or unsatisfactory treatment. In contrast to many other institutions, our standard procedure was primary ureterosigmoidostomy and, since 1990 it is completely replaced by a modification of it, the sigma rectum pouch (Mainz Pouch II). After failed primary bladder closure and in patients with short or pathological ureters or insufficient anal sphincter function, we prefer an ileocaecal pouch (Mainz Pouch I). In patients with a dilated upper urinary tract we perform an colonic conduit with the option of conversion into a continent urinary diversion.