Clinical, Sonographic and Biochemical Profiles of Patients with a Mainz II Pouch Urine Diversion in Rural Uganda. A Case Series
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Date
2025-05-24
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Abstract
Background: Mainz II pouch urinary diversion is an alternative surgery for patients with an incurable vesicovaginal fistula (VVF).
We report six (6) cases of patients who had incurable VVF and were offered Mainz II pouch surgery at Soroti Regional Referral
Hospital, between 2009 and 2018 and followed up in 2023.
Methods: A retrospective review of charts of 6 patients who were offered Mainz II pouch procedure and a cross-sectional assessment
of their biochemical, sonographic and clinical profiles five (5) or more years after the procedure at Soroti Regional Referral Hospital
were done. All case notes of patients who underwent the Mainz II procedure between 2009 and 2018 were retrieved from the registry
and each patient profiled using a standard data abstraction tool.
Results: The ages of the six participants ranged between 16 and 65 years at the time of the procedure. Four of the 6 participants had
lived with the fistula for less than 10 years. Four participants had only one delivery and the other 2 had five and six deliveries. All the
participants had lived with the Mainz II pouch urine diversion for at least five years (5–14 years). One participant (1/6) had
hypertension (BP=161/101). Most participants reported nocturnal incontinence. Sonographic findings revealed one-sided mild vesi
coureteral reflux with loss of corticomedullary differentiation in two participants (2/6). One of six (1/6) patients had severe
vesicoureteral reflux grade 4. The commonest metabolic disorders were compensated metabolic acidosis (4/6).
Conclusion: The Mainz II pouch procedure remains a viable option for managing incurable obstetric fistulas. However, the
prevalence of metabolic complications, including acidosis and renal impairment, underscores the need for routine biochemical and
sonographic monitoring to ensure optimal long-term patient outcomes.
Keywords: Mainz II pouch, vesicovaginal fistula, urinary diversion, acidosi
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All the patients provided informed written consent for publication of this manuscript.
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Citation
Fred Kirya, David Aderu, Joseph Epodoi, Denise Apolot, Ritah Kiconco, Richard Mpango, Jacob Eperu & Ronald Opito (2025) Clinical, Sonographic and Biochemical Profiles of Patients with a Mainz II Pouch Urine Diversion in Rural Uganda. A Case Series, International Medical Case Reports Journal, , 601-607, DOI: 10.2147/IMCRJ.S515145