A prospective randomized study comparing absorbable and nonabsorbable staples in constructing antireflux valves of urethral hemi-Kock pouches

Objective To determine the long-term complications associated with construc ting an antireflux nipple valve using absorbable or nonabsorbable staples i n the urethral hemi-Kock pouch. Patients and methods Fifty patients (all men, median age 47 years, range 28 -73) undergoing construction of a urethral hemi-Kock pouch were randomized prospectively into two equal groups. In group 1, absorbable (polyglyconate) staples were used for the construction. and in group 2 nonabsorbable (meta l) staples were used but omitting the staples applied at the tip of nipple valve. Assessment during the followup of 6-88 months comprised urine analys is. culture and sensitivity, measurement of serum creatinine, electrolytes and blood gases, and plain abdominal radiography, intravenous urography and micturating pouchography. Results In group 1, 21 patients were evaluable: a pouch stone was detected in one, extussusception of the valve in one and valve stenosis in one. In g roup 2, 20 patients were evaluable; pouch stones were detected in six, extu ssusception of the valve in three and Valve stenosis in one. Conclusion Compared with nonabsorbable (metal) staples, the use of absorbab le (polyglyconate) staples significantly decreased the incidence of pouch s tone formation and improved valve stability in patients with a urethral hem i-Kock pouch.