FLUOROURODYNAMIC AND CLINICAL-EVALUATION IN MALES FOLLOWING CONSTRUCTION OF A KOCK ILEAL-URETHRAL RESERVOIR

Objectives. Since 1986, we have offered the option of lower urinary tr act reconstruction with the Kock ileal-urethral reservoir in selected male patients requiring diversion. This study provides insight into th e functional characteristics of the Kock ileal-urethral reservoir and its effect on continence. Methods. Twenty-four of the initial 225 male patients undergoing this procedure at our institution were evaluated by fluorourodynamics within 2 years of neobladder construction. Inform ation regarding continence was also obtained by means of a patient int erview and questionnaire. Results. The average resting neobladder pres sure was 8.5 cm H2O (range, 0 to 18). Reservoir capacity averaged 741 cc (range, 225 to 1400). Afferent nipple failure with bilateral grade II vesicoureteral reflux was noted in 1 patient (4%). Unsatisfactory d aytime continence was seen in 2 patients (8%). Unsatisfactory nighttim e continence was seen in 6 patients (25%). Patient satisfaction was hi gh with an average rating of 8.6 on a scale of 1 to 10. Conclusions. F luorourodynamic data demonstrate a low-pressure, high-capacity reservo ir with a low incidence of reflux. The rate of continence is acceptabl e and patient satisfaction is excellent. The Kock ileal-urethral reser voir is an excellent alternative to standard diversion for the male pa tient undergoing cystectomy.