Afferent nipple valve malfunction as a late complication of the Kock continent ileal reservoir

Y. Arai, T. Matsuda, S. Hida, Y. Okada, H. Tadeuchi, O. Yoshida, Y. Kihara, S. Moroi, T. Shirahase, H. Kanamaru

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Construction of a continent ileal urinary reservoir (Kock pouch) is associated with a high incidence of late complication because of malfunction of the nipple valve, the efferent limb in particular. We have so far experienced several types of afferent nipple malfunction. We herein report on the unexpected complications of the afferent nipple valve in patients with a post operative observation of 1 year or more. From 1984 through 1989, urinary diversion via a Kock pouch was performed on 47 patients at Kyoto University Hospital and Public Toyooka Hospital. The study group comprises 42 patients with a mean observation of 40 months (range 14 to 60 months). The late complications of the afferent nipple valve were observed in 11 of the 42 (26%) patients. These included erosion of Dacron fabric used as a collar (5 patients), afferent nipple stenosis (3 patients) and afferent nipple obstruction by mucous plug or fungus ball (3 patients). Removal of Dacron collar was performed in 4 of the 5 patients with collar erosion and in 1 of the 3 patients with nipple stenosis. Nipple obstruction was relieved by endoscopic manipulation or diuresis. All of the 11 patients had no problems with their efferent nipples. Our results suggest that the use of nonabsorbable material as a collar and peristaltic direction of the afferent limb are mainly involved in the complications of the afferent nipple. A more reliable and simpler procedure for antireflux anastomosis should be considered.

Original languageEnglish
Pages (from-to)1155-1161
Number of pages7
JournalHinyokika kiyo. Acta urologica Japonica
Volume36
Issue number10
Publication statusPublished - 1990 Oct

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Afferent nipple valve malfunction as a late complication of the Kock continent ileal reservoir'. Together they form a unique fingerprint.

Cite this