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Ureteral reflux and ileal conduit pressure following diversion with a reflux-preventing technique
Abstract:
Ileal conduit urinary diversion was performed with an antireflux technique, with nippling of the ureters into the segment, in 63 patients. The patients were then followed up for 52 +/- 25 months concerning urographic findings, infections and kidney function. Ureteroileal stenosis developed in 3 of 122 ureters and was surgically corrected. Roentgenologic examination for ureteral reflux was performed about a year postoperatively, and pressure measurements were made in the ileal segment. Reflux of contrast medium was seen in 48 ureters at pressure 51 +/- 30 mm Hg. When no reflux was seen, the maximum infusion pressure was 62 +/- 34 mm Hg. The basal pressure (preceding contrast infusion) was 24 +/- 29 mm Hg. Regular contraction waves with pressure rise in the ileal segment were registered, with duration 10-30 seconds. The study showed no connection between ureteral reflux and pressure in the ileal segment. Complications associated with the antireflux operating technique were few.