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Early results with split-cuff nipple ureteral reimplants in urinary diversion
1Division of Urology, University of Texas Southwestern Medical Center, Dallas, USA.
The Journal of Urology
|December 1, 1995
Summary
A novel split-cuff nipple technique for ureteral reimplantation effectively prevents reflux in urinary diversion. This method shows promising early results with minimal complications, suggesting its potential for widespread clinical adoption.
Area of Science:
- Urology
- Surgical Techniques
Background:
- Urinary diversion procedures often require ureteroenteric anastomosis.
- Preventing reflux and complications like leakage or obstruction is crucial for patient outcomes.
Purpose of the Study:
- To introduce and evaluate a uniform split-cuff nipple technique for ureteral reimplantation in urinary diversion.
- To assess the efficacy and safety of this technique in preventing ureteral reflux.
Main Methods:
- The split-cuff nipple technique was applied to 46 ureters in 24 adult patients undergoing various urinary diversions.
- The outcomes of 42 reimplants in 22 patients with a mean follow-up of 22.5 months were analyzed.
Main Results:
- Reflux was prevented in 97.6% of cases initially and 95% at 2-year follow-up.
- No anastomotic leakage or obstruction was observed; only two early postoperative pyelonephritis episodes occurred.
Conclusions:
- The split-cuff nipple technique is straightforward to perform.
- Favorable early outcomes support its continued use, with long-term evaluation in more patients recommended.