馬偕醫院從1987年開始施行Indiana Pouch的手術，做為進行可禁性尿液分流手術。但是在最初的三位手術病人中，有兩位在手術後常常感到腹部脹痛，偶而有尿失禁的情形；並且在輸尿管進入貯尿囊的接合處發現狹窄，引起腎水腫；針對這些缺點，我們做了三項修正： (1)結腸的完全切開，避免腸蠕動，降低囊內壓力。 (2)輸尿管直接種到盲腸壁，免除以往種到腸繫膜纖維化引起狹窄。 (3)迴腸、盲腸交接處垂直縫合，增加張力，避免尿失禁。以上這三點修改使得改良後的Indiana Pouch變得更安全而有效，六年以來我們總共為20位病人施行了上述手術，除了1位死於嚴重的菌血症，2位輸尿管、結腸接合處狹窄外，其餘情況均尚稱良好，小便可貯存435到720毫升，導尿的時間從3.2小時到7.5小時，沒有尿失禁的情形。這種改良的Indiana Pouch由於安全又不需要複雜的手術技術，所以它很適合任何需要可貯尿式尿路引流手術的病人。

Use of the operation known as “Indiana pouch” for continent urinary diversion was started at Mackay Memorial Hospital in 1987. Hydronephrosis from ureterocolonic stenosis was also found. The pouch was then modified with: (1)Totally detubularization of the colonic segment to prevent bowel contraction and lower reservoir pressure; (2)Ureters anastomosed to the proper cecum wall, instead of the tenia, to prevent fibrosis and stricture; (3)Reinforced placation over ileocecal junction with two interrupted sutures to incres outlet resistance and prevent urinary incontinence. The procedures have been improved gradually with experience and were performed in 20 patients within the past 6 years. Follow-up ranged from 4 to 60 months. One mortal it occurred because of severe sepsis. Two patients had ureterocolonic stenosis and were treated with endoscopic dilation. No open surgical revision procedure was needed. All patients are continent day and night, with easy catheterization. The volume of the pouch ranged from 435 to 720 ml and duration between catheterizations, from 3.2 to 7.5 hours. The modified Indiana pouch is a safe and reliable procedure for those patients who require cutaneous urinary diversion.