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Percutaneous ureterocystostomy and ureteroneocystostomy
1Department of Radiology, Louisiana State University Medical Center, New Orleans 70112.
AJR. American Journal of Roentgenology
|May 1, 1988
Summary
Percutaneous ureteroneocystostomy offers a minimally invasive repair for severed distal ureters. This technique shows promise, particularly after hysterectomy or for certain bladder reconstructions.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Endourology
Background:
- Distal ureter injuries often require extensive surgical repair.
- Minimally invasive alternatives are sought to reduce patient morbidity.
Purpose of the Study:
- To evaluate the efficacy of percutaneous ureteroneocystostomy for distal ureter repair.
- To identify factors influencing the success of this minimally invasive technique.
Main Methods:
- A steerable sheath was introduced percutaneously via nephrostomy into the distal ureter.
- Bladder re-entry was achieved using a transseptal stylet.
- The technique was applied to 21 patients with various ureter injuries.
Main Results:
- Successful repair in 12/13 patients with ureteral transection post-hysterectomy.
- Successful repair in 4/5 patients with uretero-Boari anastomosis dehiscence.
- Complete failure in 3/3 patients with dehisced surgical ureteroneocystostomies.
Conclusions:
- Percutaneous ureteroneocystostomy is a feasible, minimally invasive option for specific distal ureter repairs.
- Adequate pelvic ureter length and preserved vascular supply are critical for success.
- The technique is less effective for dehisced surgical ureteroneocystostomies.