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Ureterosigmoidostomy: a useful procedure of internal urinary diversion in selected patients
R E Kisanga1, M M Aboud, C M Yongolo
1Department of Surgery, Muhimbili University College of Health Sciences, Dar-es-Salaam, Tanzania.
Objectives:
To determine the quality of life and complications in patients who underwent ureterosigmoidostomy for various indications.
Design:
Case series.
Setting:
Urological clinic.
Subject:
Nine patients who had good anal sphincter control and no upper urinary tract dilation, underwent urinary diversion via ureterosigmoidostomy by antireflux ureteral anastomosis. They were followed up for not less than five years.
Main Outcome Measures:
Incidence of symptomatic urinary tract infections, metabolic derangement; occurrence of upper urinary tract dilation, frequency of emptying the rectum, incidence of soiling and quality of life.
Results:
The group as whole, experienced a total of 69 years of life with ureterosigmoidostomy diversion. There were no serious post operative complications. There were two incidences of urinary tract infection in the same patients who also had upper urinary tract dilation. Metabolic derangements and gross incontinence did not occur. All patients had satisfactory quality of life.
Conclusions:
In under developed nations where patients cannot afford external appliances and the surgeon's skill for continent diversion is lacking, our results show that in properly motivated patients with a good functional anal sphincter and who are free of ureteral dilation, ureterosigmoidostomy can be a successful form of urinary diversion without the psychological and social burdens of a wet cutaneous stoma.