Experimental data on the application of a stoma prosthesis in cutaneous ureterostomy

The main problem with urinary diversion via cutaneous ureterostomy is stomal stenosis. Results with experimental and clinical implants of carbon polymer stoma prostheses (max. clinical observation period: 31 months) for vesicostomies have encouraged us to find out whether implants of this material would be suitable for cutaneous ureterostomies as well. The first step was dilation of the ureters in 16 mongrel dogs, 4 mini pigs and 4 sheep. This was done by knotting a thread over a splint which had been introduced into the ureter. After 7 days the ureter was ligated prevesically and a carbon polymer stoma was implanted into the ureter. 37 of the 48 stoma implants were well tolerated and provided water tight urinary drainage; slight encrustation occurred, but, radiologically, a smooth flow of contrast medium was seen. Ten of these 37 cases had transient urinary leakage. Eleven of the 48 stoma implants were unsuccessful because of insufficient healing, urinary extravasation, parastomal inflammation or severe encrustations. The results of these experiments on animals would seem to justify initial clinical use. It is conceiveable that this way stomal stenosis of the cutaneous ureterostomy can be avoided.