CUTANEOUS URETEROSTOMY WITH SKIN TUBE and PLASTIC CUP APPLIANCE, TOGETHER WITH TRANSURETERO‐URETERAL ANASTOMOSIS

Abstract

SUMMARY To avoid the use of a ureteral catheter in cutaneous ureterostomy a conical skin tube has been constructed round the outer end of the ureter. This has been covered with a cup appliance shaped in accordance with a plaster cast of the skin surrounding the skin tube. In two cases this operation was combined with uretero‐ureteral anastomosis. Cutaneous ureterostomy with formation of a skin tube is carried out as a first stage and the uretero‐ureteral anastomosis should be performed as a second stage, when the cutaneous ureter has become established in its new position. The patients are completely fit for work after this operation, and the trouble they experience from their appliance is so insignificant that we prefer this operation to ileocystoplasty in some cases of contracted bladder with reduced renal function.

Comparison of Ileal Conduit and Transureteroureterostomy with Ureterocutaneostomy Urinary Diversion

“…In 1980, Hendren and Hensle [10] described a series of 75 transureteroureterostomies in childhood. However, the associated use of TUU with UC as a form of urinary diversion was fi rst reported by Obrant [4] in 1957 and popularized by Hodges et al [5] ; it avoids the morbidity associated with bowel anastomosis, decreases operating time and is a viable alternative urinary diversion in patients with bladder cancer.…”

“…This segment was then brought through the abdominal wall and a rosebud stoma was matured. The techniques for TUU with UC have been described previously by Obrant [4] . The ureters were isolated with care to preserve the blood supply.…”

“…However, all of these procedures require an enteroenterostomy to reconstitute the bowel continuity, and hospitalization are increased [3] . Transureteroureterostomy (TUU) with ureterocutaneostomy (UC), described by Obrant [4] and popularized by Hodges et al [5] , avoids the morbidity associated with bowel anastomosis, decreases operating time and is a viable alternative urinary diversion in patients with bladder cancer.…”

Transuretero-ureterostomy and Cutaneous Ureterostomy as a Form of Urinary Diversion in Children

“…They also referred to a similar case described by Bi.ocksom. O brant was the first to describe uretcrourctcral cuta neous ncostomy as a form of supravesical diversion [2]. The 2 cases he reported were done in 2 stages.…”

“…The midline stoma also interferes more with social functions than does the lateral stoma. The use of transperitoneal bilateral cutaneous ureterostomy, with a single stoma in the midline [2] presents the risk of internal herniation and adhesions, and has thus not been considered advisable by our service.…”