The reimplanted ureter as a catheterizing stoma

Some current trends in the management of neurogenic bladder have been toward utilization of the urinary bladder as a storage device with a continent catheterizing stoma. This study presents a procedure using the now standard Cohen ureteral reimplantation, followed some 6 weeks later by transureteroureterostomy and distal ureteral stomal formation, after the method of Mitrofanoff. This staged procedure appears to have allowed the recently reimplanted ureter to be divided and brought to the skin as a viable catheterizing stoma. We believe that this experimental study has demonstrated that the Cohen technique of ureteral reimplantation is a reasonable antecedent to the use of transureteroureterostomy and distal ureteral stoma creation for continent catheterization. Monfort has demonstrated this clinically in one patient, and we feel that this technique deserves more extensive clinical trials.