Ileal Ureter Utilization in Patients With Previous Urinary Diversions

Area of Science:

• Urology
• Surgical Reconstruction
• Nephrology

Background:

• Ureteral strictures following urinary diversion or augmentation present complex reconstructive challenges.
• Existing literature lacks data on ileal ureter (IU) substitution into established lower urinary tract reconstructions.

Purpose of the Study:

• To evaluate the feasibility and outcomes of ileal ureter (IU) creation in patients with prior urinary diversion or augmentation.
• To assess renal function and postoperative complications in this specific patient cohort.

Main Methods:

• Retrospective review of patients (18 years) undergoing IU creation between 1989 and 2021.
• Analysis of 19 patients with IUs into prior diversions, examining demographics, stricture etiology, diversion type, renal function, and complications.

Main Results:

• Nineteen patients (16 male, mean age 57.7 years) with prior diversions (continent reservoirs, neobladders, ileal conduits, Monti channels) underwent IU creation.
• No significant difference in mean preoperative (1.5) versus postoperative (1.6) creatinine was observed (P = .18).
• Postoperative complications included infections, ileus, and urine leak; none required renal replacement therapy.

Conclusions:

• Ileal ureter reconstruction is a viable option for selected patients with ureteral strictures and prior bowel reconstructive surgeries.
• This approach can preserve renal function with acceptable complication rates in challenging urological cases.