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Related Experiment Videos

Salvaging the obstructed ureterosigmoidostomy using an ileal interposition technique

T D Allen1

  • 1Division of Urology, University of Texas, Southwestern Medical Center, Dallas.

The Journal of Urology
|October 1, 1993
PubMed
Summary

A novel surgical technique using an intussuscepted small bowel segment can salvage obstructed ureterosigmoidostomy and allow primary procedures. This method preserves patient lifestyle while potentially reducing colon cancer risk.

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Area of Science:

  • Urology
  • Surgical Innovation

Background:

  • Ureterointestinal obstruction is a significant complication of ureterosigmoidostomy, often necessitating alternative urinary diversion methods.
  • Patients frequently desire to maintain the lifestyle benefits of ureterosigmoidostomy, seeking alternatives to complete procedural change.

Observation:

  • A new surgical technique involves interposing an intussuscepted small bowel segment between the colon and ureters.
  • This approach aims to address ureteral obstruction while retaining key features of ureterosigmoidostomy.

Findings:

  • The technique successfully salvaged obstructed ureterosigmoidostomy in 6 patients.
  • It has also been employed as a primary procedure in one patient with excellent outcomes.
  • The method is suitable for primary ureterosigmoidostomy in patients with dilated ureters.

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Implications:

  • This innovation offers a viable solution for patients experiencing ureterosigmoidostomy complications.
  • It may expand the applicability of ureterosigmoidostomy, even in cases with pre-existing ureteral dilation.
  • Separating urothelium from colonic mucosa might reduce the risk of colon cancer associated with ureterosigmoidostomy.