A METHOD OF FORMING ANTIREFLUX URETEROCYSTOANASTOMOSIS AFTER BLADDER REPLACEMENT WITH A RESERVOIR FROM INTESTINE

Abstract

Aim. Improvement of surgical treatment results of patients who underwent cystectomy and orthotopic bladder replacement with an intestinal reservoir by forming antireflux ureterocystoanastomosis.Materials and methods. With the help of this method we have performed 18 surgeries on patients aged 50-68. The period of treatment has been from 1 to 48 months. Indications for surgery: bladder cancer сT2NoMo. All reservoirs have been formed with the application of the intestine detubularization principles. The follow-up of the patients was conducted after 1, 3, 6, 12 months and further after six months. Anatomical and functional state of the urinary reservoir, the upper urinary tract (ultrasound, spiral computed tomography with contrast, mictional cystourethrography and dynamic radioisotope renography) was checked and controlled; laboratory tests were done.Results.Theobtainedpreliminarydataarenotinferiorineffectivenesstoothermethods. Concavitiesureterocystoanastomosis has full patency and all the functions of the antireflux mechanism.Conclusion. The developed method of ureteroneocystostomy has a reliable antireflux mechanism that allows using it in situations when it is necessary to perform the transplant of one or both ureters into the intestinal reservoir.

Keywords

• urinary reservoir
• intestinal urine derivation
• ureterorenoscopes
• reservoir-ureteral reflux
• antireflux protection