[Clinical evaluation on long-term complications of ureterosigmoidostomy]

Although various complications such as electrolyte imbalance and urinary infections are known to be induced, ureterosigmoidostomy may still prove to be useful on selected patients who desire a continent form of internal diversion. At our hospital, we performed nineteen ureterosigmoidostomy operations in the seven years between 1981 and 1987. Herein, we have reviewed the postoperative conditions of electrolytes, renal function and other complications. The patients (17 male, 2 female) were between 43 and 75 years old, the mean being 60.3 years. The primary disease was bladder tumor with histopathological findings of transitional cell carcinoma (17) and squamous cell carcinoma (2). Post-operative fluctuations in electrolyte values of Serum Na and Serum K were within the normal value. Hyperchloremia was initially detected in four cases (21.0%), but these were only slightly above the normal range and a year after the operations the conditions were stabilized. Although blood urea nitrogen had a tendency to elevate one or two years after the operation serum creatinine fluctuated within the normal range. After the operations, we administered 10% sodium potassium citrate solution to all patients to prevent hyperchloremic acidosis. During the observation period, only four out of nineteen cases (21.0%) exhibited pyelonephritis. No other complications were observed. Postoperative excretory urograms revealed slight to medium hydronephrosis two months after the operation in four out of nineteen cases but most of these conditions were normalized within a year. Nine patients died after leaving the hospital; seven due to the recurrence of cancer and two due to pneumonia. The ten remaining patients are enjoying normal lives without the use of any external urinary device.