[Direct cutaneous ureterostomy: a new technic. Preliminary results]

Area of Science:

• Urology
• Surgical Techniques
• Nephrology

Context:

• Effective urine diversion is crucial in urological procedures, particularly after cystoprostatectomy for bladder cancer.
• Existing methods for urine bypass often face challenges with simplicity, efficacy, and preventing ureteral stenosis.
• Direct cutaneous ureterostomy presents an alternative for urinary diversion.

Purpose:

• To describe a new technique of direct cutaneous ureterostomy that combines simplicity with therapeutic efficacy.
• To present a method applicable to both narrow and dilated ureters that prevents stenosis without the need for prolonged catheterization.
• To evaluate the outcomes of this novel ureterostomy technique in patients undergoing cystoprostatectomy.

Summary:

• A new direct cutaneous ureterostomy technique is detailed, involving specific parietal crossing and a V-shaped skin flap for ureterocutaneous anastomosis.
• The procedure preserves ureteral vascularization and ensures tension-free anastomosis.
• This method was applied to 41 ureters in 23 patients with bladder cancer, with 34 ureters (82.9%) remaining patent after 18 months.

Impact:

• The described technique provides a reliable and effective method for urine bypass, reducing the incidence of ureteral stenosis.
• This approach offers a valuable option for urological surgeons managing patients requiring urinary diversion.
• The high patency rate suggests long-term success and improved patient outcomes.