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Intestinal seromuscular tunneling: a novel method for ureteral replacement—an experimental design

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Abstract

Background

Long-segment ureteral injuries may have different etiologies. Although multiple procedures have been previously used for ureteral replacement, none of them had optimum results, and replacement of long segments of injured ureter is still a challenging surgical problem. In this article, we have hypothesized that it may be possible to use intestinal seromuscular tunneling as a novel method for ureteral replacement.

Methods

This experimental study was conducted on eight dogs. After cutting the ureter at about its mid-part and ligating the distal part, a 10-cm tunnel was made in the seromuscular layer of small intestine using a metallic probe, and a catheter was passed through it. Proximal and distal ends of the tunnel were anastomosed to proximal end of ureter and urinary bladder, respectively. After 8 weeks, the dogs were killed, and their whole urinary system was sent for histopathologic examinations.

Results

No complication was noted during the post-op period. Histopathologic examinations confirmed that the seromuscular tunnel was well patent, lined by pseudostratified transitional epithelium and without any inflammatory reaction.

Conclusion

Our study shows that ureteral replacement by intestinal seromuscular tunneling is anatomically possible at least in animal model. However, more well-designed prospective studies are needed to confirm its long-term functional results.

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Acknowledgments

This article is based on the thesis of Dr. Jalal Khalili Paidar for finishing general surgery residency and financially supported by Shiraz University of Medical Sciences (Grant Number 90-01-01-4181).

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Authors and Affiliations

  1. General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran

    Hossein Hodjati

  2. Trauma Research Center, General Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran

    Jalal Khalili Paidar & Hamed Ghoddusi Johari

  3. Pathology Department, Shiraz University of Medical Sciences, Shiraz, Iran

    Perikala Vijayananda Kumar

Authors
  1. Hossein Hodjati
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  2. Jalal Khalili Paidar
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  3. Perikala Vijayananda Kumar
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  4. Hamed Ghoddusi Johari
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Corresponding author

Correspondence to Hamed Ghoddusi Johari.

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Hodjati, H., Paidar, J.K., Kumar, P.V. et al. Intestinal seromuscular tunneling: a novel method for ureteral replacement—an experimental design. Int Urol Nephrol 47, 1351–1355 (2015). https://doi.org/10.1007/s11255-015-1027-8

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  • DOI: https://doi.org/10.1007/s11255-015-1027-8

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