Evaluations for Hydronephrosis After the Establishment of Tubeless Cutaneous Ureterostomy

Abstract

PurposeTo investigate hydronephrosis after the establishment of tubeless cutaneous ureterostomy by using our definition of the tubeless condition and our indications for catheter insertion.Materials and MethodsTwenty-eight (54 renal units) patients with both establishment of tubeless cutaneous ureterostomy 3 months after surgery and at least 12 months of follow-up were investigated in this study. The 4-grade system was used to evaluate the hydronephrosis. The definition of the tubeless condition in cutaneous ureterostomy was as follows: 1) the catheter stent is not placed in the renal pelvis through the stoma, 2) the grade of hydronephrosis is less than 3, and 3) the kidney is functioning. Indications for catheter insertion after the establishment of tubeless cutaneous ureterostomy were as follows: 1) difficulty in curing acute pyelonephritis by drug treatments, 2) flank pain due to hydronephrosis, or 3) increase in the grade of hydronephrosis.ResultsThe follow-up period was 12 to 78 months (average, 40.5±22.1 months). After the establishment of tubeless cutaneous ureterostomy, 6 of 54 renal units (11.1%) were eligible for catheter insertion. The catheter insertion was performed in 4 renal units. Another 2 renal units were followed up without intervention, and they gradually became atrophic. The renal functions were preserved in the other 52 renal units.ConclusionsOur results suggest that our definition of the tubeless condition and our indications for catheter insertion would be useful for the evaluation and management of hydronephrosis after establishment of tubeless cutaneous ureterostomy.

Analysis of the efficacy of a single subumbilical stoma for bilateral cutaneous ureterostomy after radical cystectomy

“…Ureteral anastomotic stricture is a frequently encountered and particularly difficult postoperative complication in patients who have undergone diverted urinary flow surgery. The incidence of ureteral anastomotic stenosis is 8% to 22%, and ureteral and intestinal anastomotic stenosis can lead to hydroureter and renal dysfunction, as well as recurrent urinary tract infections [ 23 , 24 ]. Long-term placement of a stent tube is often required to prevent ureteral stenosis after cutaneous ureterostomy but is prone to retrograde infection, which increases medical costs [ 25 ].…”

Analysis of the efficacy of a single subumbilical stoma for bilateral cutaneous ureterostomy after radical cystectomy

“…The occurrence of long-term postoperative complications. The incidence of ureteral anastomotic stenosis is 8% to 22%, and ureteral and intestinal anastomotic stenosis can lead to hydroureter and renal dysfunction, as well as recurrent urinary tract infections [22,23]. Long-term placement of a stent tube is often required to prevent ureteral stenosis after cutaneous ureterostomy but is prone to retrograde infection, which increases medical costs [24].…”

Clinical benefits of tubeless umbilical cutaneous ureterostomy

“…With bilateral umbilical cutaneous ureterostomy, our success rate of catheter-free outcome (5/6 ureters) was comparable with previous reports with regular cutaneous ureterostomy. 10 Only one ureter (16.7%, 1/6) required catheter reinsertion. Surgical resection of bladder cancer with ureteral invasion or concomitant ureteral lesion does not preserve adequate ureter length and blood supply to the ureter.…”