Ileal substitution for ureteral loss

Abstract

Background and Objective: In patients with unilateral or bilateral loss with high length (More than 10cm) and with different etiologies, ileal substitution is good alternative when other procedures are not suitable. The objective of this study was to survey the effects and complications of ileal substitution for ureteral loss. Cases: Sixteen patients were operated in urologic ward of Shahid Labbafinejad hospital with ileal substitution for ureteral loss during 1994-1999. Twelve patients were male and four were female with mean age 28 years (3-47 years). Etiology was complications of surgery and ureteroscopy in 11 and TB in 2 and ureteral avulsion in one due to trauma. Follow up was 9-60 months and 3 patients missed follow up. Pre.op sonography, IVP and DTPA isotope scan in all patients revealed severe hydronephrosis in 11 patients. Post.op sonography and scan showed much improvement of kidney function. In 2 patients, hydronephrosis persisted that nephrectomy was performed. Conclusion: In cases with high ureteral loss, which other procedures like uretero-ureterostomy or transuretero-ureterostomy or autotransplant or kidney descending or Boari-Flap cannot be done, ileal substitution is good alternative with low complication.

Keywords

• ureter
• ileum
• ileal ureteral substitution