Use of Ileum as Ureteral Replacement in Urological Reconstruction
- 31 January 2009
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 181 (1), 177-181
- https://doi.org/10.1016/j.juro.2008.09.019
Abstract
We reviewed indications and outcomes in patients undergoing ileal ureter replacement for ureteral reconstruction. Between December 1989 and September 2007, 105 patients underwent ileal ureter replacement, of whom 14 were excluded from study due to incomplete data. The remaining 91 patients (99 renal units) comprised the study cohort. Mean patient age was 46.8 years and mean followup was 36.0 months. Indications for an ileal ureter were stricture following genitourinary surgery in 29 cases (31.9%), radiation induced stricture in 17 (18.7%), nonurological surgery iatrogenic injury in 16 (17.6%) and retroperitoneal fibrosis in 11 (12.1%). Only 4 patients (4.4%) had primary ureteral cancer. Long-term complications included anastomotic stricture in 3 patients (3.3%) and fistula in 6 (6.6%). Serum creatinine decreased or remained stable in 68 patients (74.7%) and hyperchloremic metabolic acidosis developed in 3. No patient complained of excessive urinary mucous production. In 68.1% of patients indications for an ileal ureter included radiation induced stricture or iatrogenic injury. The ileal ureter is a reasonable option for long-term ureteral reconstruction with preserved renal function in carefully selected patients.Keywords
This publication has 20 references indexed in Scilit:
- The Use of Bowel for Ureteral Replacement for Complex Ureteral Reconstruction: Long-Term ResultsJournal of Urology, 2006
- Classification of Surgical ComplicationsAnnals of Surgery, 2004
- Ileal ureteric replacement in complex reconstruction of the urinary tractBJU International, 2004
- Ileal ureter substitution: a contemporary seriesUrology, 2003
- Long-Term Results of Ileum Interposition for Ureteral ObstructionEuropean Urology, 2002
- ILEAL URETERAL SUBSTITUTION IN RECONSTRUCTIVE UROLOGICAL SURGERY: IS AN ANTIREFLUX PROCEDURE NECESSARY?Journal of Urology, 1999
- Management of Complete Ureteral Replacement: Experiences and Review of the LiteratureScandinavian Journal of Urology and Nephrology, 1997
- Further Experience with the Modified Ileal UreterJournal of Urology, 1995
- Total Replacement of Ureter with a Segment of IleumScandinavian Journal of Urology and Nephrology, 1977
- The use of ileum for correction of advanced or complicated bilharzial lesions of the urinary tractInternational Urology and Nephrology, 1972