Mainz II pouch: continent urinary diversion, for bladder extrophy epispadia complex and irreparable VVF: a 5 year comprehensive retrospective analysis

Abstract

Objective: To review the outcome of patients who underwent Mainz II pouch continent urinary diversion and assess the suitability of the technique for the treatment of bladder extrophy and irreparable VVF for use in our region of Ethiopia.

Patients and methods: Between Jan, 2004 to Nov. 30, 2008, 13 patients had continent urinary diversion for bladder extrophy epispadia complex and irreparable VVF in Mekelle hospital. All underwent Mainz II pouch urinary diversion. Adequate records have been maintained in Mekelle hospital on patients undergoing Mainz II pouch diversion. Case notes were obtained from medical records office and were analyzed for age, sex, and the indications including details of the procedure as well as treatment outcomes.

Results: There were 13 cases with bladder extrophy and irreparable VVF who underwent continent urinary diversion using Mainz II pouch technique all in Mekelle hospital. Ten (76.9%) patients had bladder extrophy epispadia complex, eight male and two female patients. Ages ranged from 6 months to 17 years in this disease category. Three (23.1%) patients had irreparable VVF following birth trauma, ages ranging from 19 to 22 years (Table 1). Mainz II pouch diversion was the mode of surgical treatment. Of the 13 patients, one patient remained incontinent after diversion and was lost to follow-up immediately after discharge. The remaining 12 patients were fully continent accounting for 92.3% of continence rate. Upper urinary tract was well preserved in most of the patietnts.

Conclusion: Mainz II pouch diversion is a procedure of choice of continent urinary diversion which is applicable in our region with high continence rate and upper urinary tract preservation without the use of external collecting devices.