Detubularised isolated ureterosigmoidostomy (Atta pouch): Manometric and radiological studies in a sample of patients

Peer review under responsibility of Arab Association of Urology.

Figures & data

Table 1 The findings on ultrasonography before and 6 months after surgery, from the pouchogram after DIUS, and the manometric findings before and after surgery.

Variable	Before	After	P
Ultrasonography, n patients
8	Normal UTs	Normal UTs
1	Left HUN	Normal upper UTs
1	Normal upper UTs	Left HUN
Reflux into upper UTs	None
Reflux into descending colon	1
High postvoid residual	None
Mean
Resting anal pressure (cmH2O)	71	74	0.004
First desire to defecate
Volume (mL)	54	72	0.004
Pressure (cmH2O)	56	46	0.006
Constant desire
Volume (mL)	106	124	<0.001
Pressure (cmH2O)	93	77	<0.001
Max. tolerated volume (mL)	140	160	<0.001
Pressure (cmH2O)	104	82	<0.001
Anorectal inhibitory reflex	Present in all	Absent in all

UT, urinary tract; HUN, hydroureteronephrosis.

Figure 1 A pouchogram taken at the 6-month follow-up, showing the pouch full at 500 mL.

Figure 2 A postvoid pouchogram from the same patient, showing complete evacuation.

Figure 3 The preoperative rectal manometry of a patient, showing a positive anorectal inhibitory reflex.

Figure 4 Postoperative rectal manometry of the same patient, showing no anorectal inhibitory reflex.