THE CAMEY-LE DUC ANTIREFLUX TECHNIQUE FOR THE KOCK POUCH - EVALUATIONOF THE UPPER URINARY-TRACT

Between November 1989 and June 1993, 41 patients (78 renal units) unde rwent Camey-Le Duc technique for prevention of reflux of a Kock pouch. In 30 patients the ileal reservoir was connected to the skin for cuta neous urinary diversion, and in 11 it was connected to the urethra for lower urinary reconstruction. The mean postoperative follow-up period was 23 months, with a range of 6-47 months. Postoperative excretory u rography (IVP) was performed at least once a year to evaluate the uppe r urinary tract configuration, and ascending cystography was performed to evaluate the reflux. No urinary tract dilatation was observed in 7 3 renal units (93.6%), while slight dilatation was noted in 3 (3.8%), moderate dilatation in 1 (1.3%), and marked dilatation in 1 (1.3%). Re flux was not found in any patient. Of 23 renal units in 12 patients in whom the last IVP examination was performed 6 months postoperatively, dilatation was noted in 4 (17.4%). In contrast, of 55 renal units in 29 patients in whom the last IVP examination was performed 12 months o r more after the Kock pouch operation, dilatation was noted in only 1 (1.8%). We conclude that the Camey-Le Duc antireflux technique is effe ctive in terms of simplicity and reliability.