Low loop cutaneous ureterostomy and subsequent reconstruction: 20 years of experience

Between 1970 and 1990 we constructed low loop cutaneous ureterostomies in 50 patients with grossly dilated collecting systems. Patient age ranged from 6 days to 3 years. The indication for all urinary diversions was an anomaly of the lower urinary tract associated with marked ureteral dilatation considered to require decompression because of either urinary tract infections or renal functional impairment. Clinical and radiological followup was maintained between establishment of the cutaneous ureterostomy and complete reconstruction, and revealed marked improvement indistinguishable from that obtained by high diversions. Undiversion was performed after 3 to 69 months, usually simultaneously with definitive correction of the underlying anomaly. The main advantage of our presented technique is the opportunity to resect the distal ureteral limb and to perform simple ureteroneocystostomy using the proximal limb. Besides its technical simplicity, this technique obviates possible complications that may be attributed to ureteral anastomosis and compromised blood supply, thus, it is well recommended.