[Plastic repair of the urinary tract with intestinal graft]

Enteroplasty of the urinary tract was made in 224 patients (175 male and 49 female, age 21-72 years): enteroplasty of the ureter (n = 25), augmentation cystoplasty (n = 38), replacement of the urinary bladder after radical cystectomy for cancer (n = 161). The grafts were made of the small intestine segments--149 (66,5%), sigmoid--45 (20%), stomach--25 (11.2%), appendix--3 (1.3%). Total postoperative lethality reached 2.7%. Early and late complications occurred in 26.8 and 32.2% patients, respectively. In half the cases complications were related to the derivation method. Fifty three reoperations were made, most frequent of them was percutaneous nephrostomy. Thus, use of gastrointestinal tract segments for replacement of the urinary tract provides adequate urine outflow from the kidneys, close to natural micturition. Introduction of advanced methods of urine derivation prevents formation of urinary fistulas and improves quality of the patients' life.