{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T07:18:01Z","timestamp":1783495081281,"version":"3.55.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Fakult\u00e4t Mannheim der Universit\u00e4t Heidelberg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The sigmoid rectum pouch (SRP) is a continent anal urinary diversion that may cause long-term complications requiring revision. This study describes our bowel-sparing surgical (BSS) technique for conversion to a continent cutaneous urinary diversion (CCUD) and evaluates functional outcomes and quality of life (QOL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed all patients undergoing SRP-to-CCUD conversion at our tertiary referral center between 2015 and 2020. Clinical records and follow-up data were reviewed. Endpoints included serum creatinine, urinary tract infections, pouch capacity, urinary continence (International Consultation on Incontinence Questionnaire [ICIQ]), fecal continence (Wexner score), and QOL (EuroQol-5D-5\u00a0L). Descriptive statistics were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven patients underwent conversion at a mean age of 32 years with a mean follow-up of 91 months. All procedures were successfully completed using a BSS approach preserving bowel length. No severe postoperative complications (\u2265\u2009CDC 3) occurred. Renal function remained stable (mean preoperative serum creatinine 0.92 vs. 1.00\u00a0mg\/dL postoperatively). Severe urinary tract infections decreased postoperatively. One-third of patients achieved full urinary continence, one-third mild, and one-third moderate incontinence. Fecal continence remained stable (four patients with perfect, three with good continence). QOL was favorable (mean EQ-5D-5\u00a0L index 0.93; mean VAS 76), with all patients reporting subjective improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BSS conversion of SRP to CCUD is a feasible option in selected patients, preserving bowel length while maintaining renal function, acceptable continence, and good QOL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00423-026-04110-6","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:23:47Z","timestamp":1783473827000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Conversion of a sigma rectum pouch to a continent cutaneous urinary diversion \u2013 enhancing quality of life through a bowel-sparing surgical approach"],"prefix":"10.1007","volume":"411","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2053-5478","authenticated-orcid":false,"given":"Margarete Teresa","family":"Walach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimund","family":"Stein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Nientiedt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"issue":"1","key":"4110_CR1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1159\/000475238","volume":"25","author":"M Fisch","year":"1994","unstructured":"Fisch M et al (1994) The Mainz pouch II. 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Hand-drawn surgical illustrations were converted into digital figures using AI-assisted tools; all figure content and design were created and verified by the authors. The authors reviewed and edited all content and take full responsibility for the published work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"AI assistance statement"}},{"value":"The protocol for this research project has been approved by a suitably constituted Ethics Committee of the institution and it conforms to the provisions of the Declaration of Helsinki. University of Heidelberg\u2019s Ethics Committee II, Medical Faculty Mannheim, reference number 2021\u2009\u2212\u2009893.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement of ethics"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"187"}}