الفهرس 
1. IntroductionOnly 14 pages are availabe for public view
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Abstract
Urinary diversion in previously irradiated patients has proven to be a challenge which has been addressed with several different techniques. There is a high rate of early and late complications using small bowel segments and ileocaecal reservoirs.
Based on the high risk of failure in reconstructive surgery in the irradiated field, and on the high complication rate after using irradiated tissue for urinary diversion, the ’avoidance’ principle was adopted with unirradiated large bowel segments being used for continent urinary diversion.
With the cranial position outside the irradiation field transverse colon fulfills the demand to be unirradiated, which is of utmost importance for segment to be used for urinary diversion.
In this study we retrospectively evaluated the outcome of 43 patients, who underwent reconstructive surgery using the transverse colon. n=23 patients and n=20 received a transverse colon pouch (Mainz lll pouch) and a transverse colon conduit respectively.
Mean age of all patients was 50 years (range 19-81).
Patients with transverse colon pouch included 15 (65.2%)females and 8 (34.8%) males. Patients with transverse colon conduit included 10 (50%) males and 10 (50%) females. The average follow-up of the patients was 52.2 months (range 1-104 months).
During follow up of all cases stone formation occurred in one case (2.3%), hydronephrosis occurred in 4 cases (9.3%), stricture at the uretero-enteral implantation site in one case (2.3%), and nonsignificant electrolyte disturbance occurred in 3 cases (6.9%).Of the pouch group stomal stenosis occurred in 2 cases (8.6%)and stomal insufficiency in 3 cases (13%). No stoma related complications in conduit group. In all patients there was no deterioration of renal function, no significant electrolyte disturbance, no diarrhea related to urinary diversion, no bone pains or pathological fracture and no symptoms of vit. B12 deficiency.
A short form questionnaire showed good acceptance by patients and families. The answer of patients showed that from all patients that 95% are satisfied, with 97.7% choosing the same procedure again. 95.3% would recommend the procedure to others with the same indication. 97.7% are content with the effects of the procedure. 88.2% have no residual discomfort related to the urinary diversion.