A large calculus (6.0 x 4.5 x 7.0 cm sized) in the continent urinary pouch was detected incidentally by computed tomography in a 7-year-old man with a gall bladder stone. He underwent a total cystectomy and Mainz pouch formation using appendix as the efferent limb for bladder cancer 7 years ago. Urine culture showed Proteus mirabilis and Escherichia coli, and urine pH was 8.5. The stone was removed successfully through a pouchotomy and composed mainly of struvite. The stone analysis was MAP; 88% and CaCO3; 12%. Convalescence was uneventful. This is the first case of in Mainz pouch using appendix as the efferent limb.

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http://dx.doi.org/10.5980/jpnjurol1989.93.573DOI Listing

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