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Ureteroileourethrostomy: 16-year followup
The Journal of Urology
|January 1, 1976
Summary
Ureteroileourethrostomy for bladder replacement was abandoned due to compromised cancer surgery and upper urinary deterioration. Future use may be possible with prostate removal, managing retention and acidosis with specific interventions.
Area of Science:
- Urology
- Surgical Oncology
- Reconstructive Surgery
Background:
- Bladder cancer necessitates cystectomy and urinary diversion.
- Ureteroileourethrostomy was explored as a bladder replacement technique.
Observation:
- The procedure compromised oncologic resection in bladder cancer cases.
- Two of three patients experienced upper urinary tract deterioration requiring conversion to ureteroileocutaneous diversion.
Findings:
- Ureteroileourethrostomy's oncologic compromise and high rate of upper tract deterioration led to its abandonment.
- Successful management of urinary retention via intermittent self-catheterization is feasible.
- Hyperchloremic metabolic acidosis can be managed with reduced residual urine and potassium citrate.
- Antirefluxing ureteroileal anastomoses may prevent upper urinary tract changes.
Implications:
- Ureteroileourethrostomy may be viable for bladder cancer if the prostate is fully removed during cystectomy.
- Clean intermittent self-catheterization offers a solution for urinary retention.
- Metabolic acidosis and upper tract changes are manageable with specific interventions.
- Refined surgical techniques could potentially enable future applications of ureteroileourethrostomy.