Reimplanted ureter as an alternative to the catheterizable Mitrofanoff tube

We performed this study in dogs to investigate whether a ureter can be used as an alternative to the appendix without disrupting the uniformity of the gastrointestinal system.

This study comprised 10 adult healthy female mongrel dogs. The procedure was done in 2 stages: in the first stage, we performed a left-end cutaneous ureterostomy at the lower left quadrant just above the inguinal ligament. A second operation was performed 6 weeks later. The left ureter was divided and using Paquin's technique, the proximal end of the distal third of the left ureter was reimplanted in the anterolateral surface near the dome of the bladder. A high transureteroureterostomy with the remaining left proximal ureter to the opposite ureter completed the reconstruction. The bladder neck was ligated in order to create an experimental bladder outlet obstruction. At the time of creating the distal ureteral stoma, a feeding tube was left in the bladder, passing through the ureterostomy stoma and sutured to the skin. This catheter remained in place for 20 days, preventing the bladder form distending. Then in the following 6 months, intermittent catheterization was applied through the stoma at 3- to 4-hour intervals. Exploration was performed at the end of the 6th month.

No animal died. The dogs were still continent. Intravenous urography, urea and creatinin values were normal. The ureteral stoma was viable in all 10 cases. Stenosis of the ureteral stoma developed in 1 dog and required surgical revision. Possible traumatic effects were investigated by histological sections, but no harmful effects were found at the ureteral endothelium.

This method may be an alternative to the Mitrofanoff method, which uses the appendix.