Urodynamic Evaluation of the Causes of Incontinence of Ileocecal Reservoires of The "Indiana Pouch" Type
Abstract
Heterotopic reservoire of the "Indiana pouch" type, created by detubulisation of caecum and ascendens and draining of terminal ileum loop in abdominal wall is one of the option of continent derivation of urine. The authors try to evaluate the causes of incontinence of these reservoirs on the basis of urodynamic examination.
Continence of heterotopic reservoirs depends on two factors: The pressue inside the reservoire and the closing pressure in the outflow part. 11 (39,3%) out of 28 patients were fully continent, 9 (32,1%) were satisfactorily continent and 8 (28,6%) pacients were incontinent. The group of patients suffering from incontinence of the reservoire of "Indiana pouch" type had significantly decreased capacity and compliance of the reservoire when compared with continent patients.
The cause for incontinence caused by possible insufficiency of the outflouw part could not be urodynamically detected in this group. The cause can be imperfection of the measuring method of static one-channel profilometry, as well as the complexity of the functional relations in the ileocaecal area, which can be the cause of a difficult reproducibility of profilometric invedtigation of the outlfow part of the reservoire.