Abstract
Ileal conduit and orthotopic bladder substitution have been the preferred options for urinary diversion after cystectomy. Self-catheterisation has revolutionised the management of neuropathic bladder. However, ureterocutaneostomy (cutaneous ureterostomy) described as a means of supravesical urinary diversion 40 years ago still has a definite role for both temporary and permanent diversion particularly in the developing countries. We present a small series of cutaneous ureterostomies performed in four children who have now grown up to become adults without being undiverted. We discuss the technique that we used to modify the stoma, which helped prevent stomal complications over the long term. Our results we believe will rekindle the interest in cutaneous ureterostomy as a viable option for permanent urinary diversion. Four children between ages 2 and 16 years had bilateral side-to-side single stoma tubeless end cutaneous ureterostomy as a primary procedure for permanent urinary diversion. The stoma was modified to prevent retraction and stenosis. Long-term follow-up is presented. All the children have grown up to become adults with their ureterocutaneostomies functioning very well. There have been no biochemical or mechanical complications. Only one out of four stomas had to be refashioned. A simple collection device has proved successful in maintaining a watertight drainage system without apparent problems. Bilateral side-to-side single stoma end cutaneous ureterostomy with modification of the stoma by a plastic surgical technique can help achieve a non-retracting stoma on which a collection device can snuggly fit. It is a viable option for permanent urinary diversion without any significant complications. It is simple, easy and highly practical way of managing urinary diversion especially in the developing countries.
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References
Johnston JH (1963) Temporary cutaneous ureterostomy in the management of advanced congenital urinary obstruction. Arch Dis Child 38:161–166
Rintoul RF (ed) (1986) Operations on the breast. Farquharson’s TB of operative surgery, 7th edn, Chap. 13. Churchill-Livingstone, UK, pp 270–182
Straffon RA, Kyle K, Corvalan J (1970) Techniques of cutaneous ureterostomy and results in 51 patients. J Urol 103:138–146
Castro JE, Ram MD (1970) Electrolyte imbalance following ileal urinary diversion. Br J Urol 42:29–32
Macgregor PS, Montie JE, Straffon RA (1987) Cutaneous ureterostomy as palliative diversion in adults with malignancy. Urology 30(1):31–34
Kearney GP, Docimo SG, Doyle CJ, Mahoney EM (1992) Cutaneous ureterostomy in adults. Urology 40(1):1–6
Feminella JG Jr, Lattimer JK (1971) A retrospective analysis of 70 cases of cutaneous ureterostomy. J Urol 106(4):538–540
McCoy RM, Rhamy RK (1970) Ileal conduits in children. J Urol 103:491–495
Malek RS, Burke EC, De Weerd JH (1971) Ileal conduit urinary diversion in children. J Urol 105:892–900
Creevy CD (1960) Renal complications after ileac diversion of urine in non-neoplastic disorders. J Urol 83:394–397
Schmidt JD, Hawtrey CE, Flocks RH, Culp DA (1973) Complications, results and problems of ileal conduit diversion. J Urol 109:210–216
Wallace DM (1970) Ureteroileostomy. Br J Urol 42:529–534
Chute R, Sallade RL (1961) Bilateral side-by-side cutaneous ureterostomy in the midline for urinary diversion. J Urol 85(3):280–283
Shapiro SR, Peckler MS, Johnston JH (1976) Transureteroureterostomy for urinary diversion in children. Urology 8:35–38
Rickwood AMK (1982) Urinary diversion in children. In: Ashken MH (ed) Urinary diversion. Springer-Verlag, Berlin Heidelberg New York, pp 22–58
Perinetti EP (1982) Palliative urinary diversion. Surg Clin North Am 62(6):1025–1034
Parag P, Sen S, Chacko J, Zachariah N, Thomas G, Mammen KE (2001) Bilateral high loop ureterostomy in theprimary management of posterior urethral valves in a developing country. Pediatr Surg Int 17:157–159
Hirokawa M, Iwasaki A, Yamazaki A, Asakura S, Nozaki A, Yamagishi T (1989) Improved technique of tubeless cutaneous ureterostomy and results of permanent urinary diversion. Eur Urol 16:125–132
Namiki T, Yanagi S (1995) A new technique for bilateral single stoma loop cutaneous ureterostomy. J Urol 154:361–363
Cukier J, Charbit L, Terdjman S, Nahas W (1984) Direct cutaneous ureterostomy: a new technic: preliminary results. J Urol 90:345–350
Lopatkin NA, Mazo EB, Vartanyan OK (1976) Method of choice for urinary diversion in surgical treatment of bladder carcinoma. Int Urol Nephrol 8:113–120
Sato S et al (2000) Trans-mesosigmoid cutaneous ureterostomy. Int J Urol 7:104–109
Puppo P, Ricciotti G, Bozzo W, Pezzica C, Geddo D, Perachino M (1995) Videoendoscopic cutaneous ureterostomy for palliative urinary diversion in advanced pelvic cancer. Eur Urol 28:328–333
Loisides P, Grasso M, Lui P (1995) Laparoscopic cutaneous ureterostomy: technique for palliative upper urinary tract drainage. J Endourol 9:315–317
Puppo P, Ricciotti G, Bozzo W, Pezzica C, Geddo D, Perachino M (1996) Videoendoscopic retroperitoneal cutaneous ureterostomy. Tech Urol 2:10–15
Altarac S, Janetschek G (1997) Retroperitoneoscopic cutaneous ureterostomy. Scand J Urol 31:301–303
Puppo P, Perachino M, Ricciotti G, Bozzo W (1994) Laparoscopic bilateral cutaneous ureterostomy for palliation of ureteral obstruction caused by advanced pelvic cancer. J Endourol 8:425–428
Maruyama K, Yajima A, Torii T, Naitoh Y, Toyoda Y, Ogawa H (1991) Clinical results of tubeless cutaneous ureterostomy by Toyoda’s method. Hinyokika Kiyo 37:243–248
Acknowledgment
The authors would like to thank for using Fig. 1 for Cutaneous Ureterostomy Rob & Smith Operative Surgery: Urology Ed 3 Butterworth & Co. Ltd., 1977 154.
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Chitale, S.V., Chitale, V.R. Bilateral ureterocutaneostomy with modified stoma: long-term follow-up. World J Urol 24, 220–223 (2006). https://doi.org/10.1007/s00345-006-0080-4
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DOI: https://doi.org/10.1007/s00345-006-0080-4