A Technique Which We Should Consider More: Temporary Cutaneous Ureterostomy

Abstract

Objective:To evaluate the feasibility, efficacy and complications of cutaneous ureterostomy (CU) in different indications.Materials and Methods:Data from 83 patients who underwent CU between 1991 and 2019 were reviewed retrospectively. Patients with neurogenic bladder, posterior urethral valves, solitary kidney and bilateral kidney involvement were excluded. A total of 53 patients aged <2 years were included in the analysis. Indications to perform CU were ureterovesical junction obstruction (UVJO) and high-grade vesicoureteral reflux (VUR) with dilatation. Ureteroureterostomy or ureteroneocystostomy methods were preferred for undiversion according to the dilatation status of the ureter.Results:The mean patient age was 4.47±3.6 months, 40 (75.5%) were male and 13 (24.5%) were female. The mean follow-up time was 57.4±41.4 (6-150) months. Loop and end CU were performed in 18 (34%) and 35 (66%) patients, respectively. The indications for CU were UVJO in 26 (49%) and high-grade VUR in 27 patients. Two (3.7%) patients needed dilatation because of stenosis that occurred after CU. Within the follow-up time, 39 patients underwent undiversion. The clinical improvement rate was 94.3%.Conclusion:CU is a simple method with satisfactory results when performed in patients with megaureter and massive dilatation. Despite the less frequent use, it is still an important alternative to the increasingly used conservative methods.

Keywords

• cutaneous ureterostomy
• urinary diversion
• hydronephrosis
• megaureter
• vesicoureteral reflux
• ureterovesical junction obstruction