Early observations on 31 adults with non-refluxing colon conduits

A colonic segment with tunneled ureterocolic anastomoses was used for non-refluxing urinary diversion in 31 adults during the last 3 1/2 years. Half of the patients had undergone diversions previously. These pre-existing diversions had been associated with significant urologic complications. The remainder of the patients had a variety of benign and malignant diseases. After the non-refluxing colonic diversion all upper tracts remained stable or improved except in 3 patients in whom 4 ureterocolic anastomoses developed silent stenosis. Of 10 patients who had pre-existing refluxing diversion and episodic acute pyelonephritis 7 had no recurrences. No patient with sterile urine became infected and 18 of 24 patients with persistently infected urine improved. The anatomic versatility of the colon that allows the benefits of a low pressure system and unidirectional urine flow makes the non-refluxing colon conduit an advantageous alternative in adults requiring urinary diversion.