Long–Time Experience with the Kock Ileal Reservoir for Continent Urinary Diversion

Abstract

Objectives: N.G. Kock performed the first continent cutaneous ileal reservoir for urinary diversion in 1975 at the Sahlgrenska University Hospital, Göteborg, Sweden. We have investigated the fate of the patients operated during the following 25 years at this hospital and analyzed their health–related quality of life (SF–36) as well as their psychological adjustment to a life with a continent urinary reservoir (OAS). Material and Methods: Between 1975 and 1999, 176 patients underwent continent urinary diversion using a Kock reservoir. At the end of 1999, 126 patients were known to be alive. Their reservoir function was estimated from their journals as well as from a questionnaire answered by the patients. Results: Almost 90% of the survivors had a well–functioning reservoir at the time of follow–up. The need for reoperation has been high, mainly due to nipple problems. Kidney function is not influenced by the continent diversion per se. The health status of the patients is more influenced by the underlying disease than by their reservoirs. Patients with benign functional or inflammatory diseases experience comparatively more problems with their reservoirs. Conclusions: The functional end results as well as patient acceptance of continent urinary diversion with a Kock reservoir are excellent.