R S Purohit1, P N Bretan. 1. Department of Urology, University of California-San Francisco, USA.
Abstract
PURPOSE: We report our long-term experience with a preexisting native cutaneous ureterostomy via an ipsilateral transplant ureteral native ureterostomy for transplant drainage without native nephrectomy. MATERIALS AND METHODS: Between 1993 and 1998, 5 patients without a usable bladder had undergone previously urinary diversion via cutaneous ureterostomy. All patients had a well functioning cutaneous ureterostomy for a mean plus or minus standard deviation of 18+/-12 years before renal transplantation. No patient had a history of stomal stenosis, recent urinary tract infection or pyelonephritis. RESULTS: All 5 patients continued to have a functioning renal transplant at last mean followup of 36+/-6.6 months. Complications included stomal retraction due to postoperative weight gain requiring revision in 2 cases and ureteroureteral anastomotic stenosis treated with endopyelotomy in 1. Mean serum creatinine at last followup was 1.5+/-0.6 mg./dl. CONCLUSIONS: Of the complications that we present only 1 may be attributed to the singularity of our procedure. Our experience suggests that a preexisting native cutaneous ureterostomy may serve as a receptacle for transplant ureteral drainage in select patients with excellent long-term function.
PURPOSE: We report our long-term experience with a preexisting native cutaneous ureterostomy via an ipsilateral transplant ureteral native ureterostomy for transplant drainage without native nephrectomy. MATERIALS AND METHODS: Between 1993 and 1998, 5 patients without a usable bladder had undergone previously urinary diversion via cutaneous ureterostomy. All patients had a well functioning cutaneous ureterostomy for a mean plus or minus standard deviation of 18+/-12 years before renal transplantation. No patient had a history of stomal stenosis, recent urinary tract infection or pyelonephritis. RESULTS: All 5 patients continued to have a functioning renal transplant at last mean followup of 36+/-6.6 months. Complications included stomal retraction due to postoperative weight gain requiring revision in 2 cases and ureteroureteral anastomotic stenosis treated with endopyelotomy in 1. Mean serum creatinine at last followup was 1.5+/-0.6 mg./dl. CONCLUSIONS: Of the complications that we present only 1 may be attributed to the singularity of our procedure. Our experience suggests that a preexisting native cutaneous ureterostomy may serve as a receptacle for transplant ureteral drainage in select patients with excellent long-term function.