Quality of life: the continent ileostomy.

Ten patients are presented in whom a continent ileostomy (internal ileal reservoir or Kock Pouch) was constructed. The series is unique in that it includes the first such ileostomy successfully constructed in this country. The other 9 patients, for a variety of reasons, sought conversion from a standard ileostomy with an external appliance, to a continent ileostomy. Eight of 9 were successfully converted. Subsequent loss of continence has occurred in 2 of the patients due to reduction or intususception of the nipple valve. In one of the two, a satisfactory level of continence appears related to adequate pouch size. The second patient is seriously inconvenienced by a varying level of continence in part related to slow development of pouch size. Seven of the 10 attest to a dramatic improvement in life style, and illustrate the high level of patient satisfaction with a continent ileostomy.