[A new method of ureter-sigmoid anastomosis in bladder exstrophy]

A new ureterosigmoidostomy (USS) procedure in exstrophy of the bladder in children comprises establishing a long submucous channel (SC) in the upper or middle third of the sigmoid. This is done by tenial, atraumatic for the mucosa, cut of the sigmoid wall followed by mucosal dissection along the length 2-3 mm larger than the diameter of previously immobilized ureter. After that a special instrument creates upwards an oblique SC, the ureter is placed into the SC opening made in the wall musculoserous layer. Finally, the shunt is established. The same USS procedure was conducted on the other ureter 3-4 cm above the previous shunt. The openings are intubated. Follow-up conducted for 6 years at best showed a complete urine retention existence in 7, a partial one in 1 cases. Radiologically, renal function improved in all the patients. Neither enteropelvic reflex, nor urolithiasis were observed.