Introduction. The choice between continent and incontinent heterotopic urinary diversion after cystectomy still depends on the surgeon's preferences and experience. It is necessary to increase urologists' awareness of the advantages of continent cutaneous urinary diversion methods, which will expand the range of urinary diversion options offered to patients and improve their safety.
Objective. To compare the morbidity and safety of the modified Kock continent cutaneous urinary diversion with the «gold standard» – the Bricker conduit.
Materials and methods. A comprehensive comparative analysis was performed of our modified Kock continent cutaneous urinary diversion (mKock) – 27 patients, versus the incontinent Bricker conduit – 86 patients, where cystectomy and urinary diversion were performed via open surgery.
Results. No significant differences were revealed in the number of patients with complications – 48.8% in Bricker vs 55.5% in mKock, with a complication rate per patient of 0.779 vs 0.778, respectively. No significant differences were also revealed between the complications for the entire observation period, including delayed observation period (>90 days), 82.6% Bricker vs 77.8% mKock and 1.755 vs 1.629, respectively, including in the number of patients with severe complications (III–V according to Clavien-Dindo) – 33.7% Bricker vs 33.3% mKock (p>0.05), which proves comparable morbidity and safety of the modified mKock urine derivation and the Bricker conduit.
Conclusion. The modified Kock continent cutaneous urinary diversion is a justified and safe alternative for selected, motivated patients wishing to avoid a wet stoma, provided they are informed about the long-term risks and the necessity of long-term monitoring.
