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Current indications for cutaneous ureterostomy

M A Rosen1, D R Roth, E T Gonzales

  • 1Scott Department of Urology, Baylor College of Medicine, Houston, Texas.

Urology
|January 1, 1994
PubMed
Summary
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Loop cutaneous ureterostomy (LCU) offers temporary urinary diversion for obstructive uropathy in children. End cutaneous ureterostomy (ECU) provides long-term diversion for complex cases, with potential for later reversal.

Area of Science:

  • Pediatric Urology
  • Surgical Techniques
  • Urinary Diversion

Background:

  • Cutaneous ureterostomy is a surgical procedure for urinary diversion in children.
  • Indications and outcomes vary between loop and end techniques.
  • Understanding these differences is crucial for optimal patient management.

Purpose of the Study:

  • To evaluate the current indications for performing cutaneous ureterostomy in pediatric patients.
  • To differentiate the use cases for loop cutaneous ureterostomy (LCU) versus end cutaneous ureterostomy (ECU).

Main Methods:

  • Retrospective review of 32 children who underwent cutaneous ureterostomy between 1975 and 1990.
  • Analysis of urologic diagnosis, reason for diversion, ureterostomy type, and patient outcomes.

Related Experiment Videos

Main Results:

  • Loop cutaneous ureterostomy (LCU) was performed in 20 patients, primarily for obstructive uropathy unresponsive to lower tract drainage (e.g., posterior urethral valves).
  • End cutaneous ureterostomy (ECU) was performed in 12 patients, typically older children with poor bladder function due to congenital anomalies (e.g., prune-belly syndrome, bladder exstrophy).
  • LCU served as temporary drainage, while ECU was used for longer-term diversion.

Conclusions:

  • LCU is a straightforward method for temporary upper urinary tract drainage.
  • ECU is suitable for long-term diversion in children with dilated ureters, offering a socially acceptable stoma for delayed reconstruction.
  • Advancements in reconstructive techniques may allow for reversal of ECU in some cases.