Which tissues compose the Indiana pouch reservoir?

• A. Large intestine and ileum
• B. Stomach
• C. Urethra and bladder
• D. Sigmoid colon only

Answer: (A)

The Indiana pouch reservoir is built from detubularized segments of intestinal tissue to create a low-pressure, expandable storage space for urine. It combines tissue from the ileum (small intestine) with a portion of the large intestine (colon), leveraging the properties of both to provide adequate capacity and compliance. Detubularization reduces peristaltic activity and creates a smooth, compliant cavity, while the intestinal mucosa contributes to a stable reservoir with the ability to be catheterized through a surgically fashioned stoma. The ureters are connected to this pouch, and a catheterizable channel to the abdominal wall enables intermittent emptying. Using stomach tissue is avoided due to acid-related issues, and relying on only sigmoid colon would limit capacity and isn’t typical for this configuration, while the goal isn’t to use native bladder/urethra as the reservoir.