O. Jonsson et al., STABILIZATION OF THE NIPPLE BASE WITH TITANIUM RINGS WHEN REOPERATINGPATIENTS WITH CONTINENT UROSTOMIES FOR NIPPLE DYSFUNCTION, Scandinavian journal of urology and nephrology, 30(1), 1996, pp. 51-56
Nipple dysfunction in Kock reservoirs used for continent urinary diver
sion is usually caused by a flattening out of the intestinal nipple du
e to a lateral tore at the base of the nipple when the reservoir expan
ds. This study describes a new method to repair dysfunctioning nipples
based on the use of titanium rings applied outside the reservoir arou
nd the base of the nipple. Experiments on dogs and rats have shown tha
t rings and plates of titanium rapidly attach to the serosal surface o
f ileum exposed to urine with only minor signs of inflammation. Ten pa
tients with Kock reservoirs for urinary diversion have been reoperated
for nipple dysfunction due to nipple sliding with elongation of the n
ipple and fixation of the nipple base with titanium rings. The functio
nal result is excellent in 9 out of the 10 patients. No signs of erosi
on of the rings into the reservoirs have been noted. With this new met
hod for nipple repair the need for using more intestine to construct a
new nipple is eliminated.