Ureteral replacement with a new synthetic material: Gore-Tex

There are no currently accepted synthetic ureteral substitutes. When faced with the need for ureteral replacement, the urologist must resort to pedicle grafts of intestine or bladder. Based on encouraging preliminary work in Europe, we have used a new synthetic vascular substitute, Gore-Tex, to replace segments of ureter in the dog. This material is made of expanded (microporous) polytetrafluoroethylene. In vascular surgery it is currently the preferred material due to its non-wetting and non-clotting surface when used in the arterial and venous beds. Adult mongrel dogs underwent segmental replacement of the right ureter and subtotal replacement of the left ureter with segments of 5-mm. tubed Gore-Tex. All anastomoses were performed with running 6--0 prolene. Antibiotics were given routinely perioperatively. Data on 7 dogs are available. Results indicate that Gore-Tex is well tolerated as a ureteral substitute to bridge gaps between segments of ureter. Anastomoses of Gore-Tex to bladder were not successful, resulting in infection and migration of the prosthesis. Under proper circumstances, Gore-Tex can be a useful potential addition to the urologic armamentarium.