BCIR or Kock Pouch?

[Don Anders]

I'm new to this board and looking forward to help in deciding which direction to go...BCIR or Kock? I'm a 15-yr J-poucher that has become dysfunctional...incontenence, hi-frequency, burning, pressure, etc., and trying to find the silver-bullet answer to which is the next best option. I'm scheduled for a BCIR (St. Petersburg) but reading some of the posts causes me to pause to consider a Kock. In laymen's terms can anyone define the main differences in the two, and which would be the better option. I know we're all different and each has to make an educated decision, but it's not clear to me which trumps the other and why. Any help would be greatly appreciated.

[JustDean]

The BCIR is the 'improved' version of the Kock pouch. Different suture line, improved valve, improved slippery nipples....err...improved nipple to reduce chance of slippage. If I was going to have one done I would go for the BCIR.

[Flemmart]

The kpouch valve has been long revised and both the kpouch and bcir have the same valve slippage percents. If a surgeon tells you otherwise, it's not true.

There is no other difference, both will have a small stoma that require a catheter to empty the internal reservoir.

The main thing to do is to use a qualified surgeon in either techique. And, get patient referrals!

Here's a link to a forum that may help you in your decision.

http://j-pouch.org/eve/forums/a/frm/f/5531006091

[JustDean]

Good info for sure, thanks for that! Is there any place to read about the updates to the kock pouch?

I think this link is where I read about the differences - http://bcirhistory.com/#differencesbetweentheKoch

But I also read something about the kock method uses mesh?

[Flemmart]

The BCIR is heavily promoted and those sites promote those surgeons and will talk about the problem with kock valves. The Cleveland Clinic, Scripps and other top colorectal surgeons who perform the kock pouch do not have websites or advertisements that I have found.

Personally, either way, I would only have a colorectal surgeon perform my ostomy whether I had a kock pouch, bcir or perm ileo. There are specific issues related to colorectal surgeries (alot of nerves for example) I would prefer a specialist over a general surgeon.

[Lynne]

Don,

The BCIR and Kock Pouch are both Continent Ileostomies, with minor differences. They are named for the surgeons who devised them. The information suggested so far to you about using an experienced colorectal surgeon is good. You want someone who has lots of experience and not someone who is getting their experience on YOU !

I have had my Kock Pouch since 1990 after 13 years of a traditional ileostomy and am happy to report no problems whatsoever. I'd be glad to answer any questions you might have.