Retroperitoneal Ureterocyctoplasty in Bilaterally Functional Kidneys

Document Type : Original Article

Authors

1 Associate Professor of Urology Surgery, Iran University of Medical Sciences and Health Services, Shahid Hasheminejad Hospital, Tehran, Iran

2 Resident of Urology Surgery, Iran University of Medical Sciences and Health Services, Shahid Hasheminejad Hospital, Tehran, Iran

Abstract
Introduction & Objective: Traditional augmentation cystoplasty using gastrointestinal segments is known to be associated with metabolic abnormalities and alterations in the bladder causing potential carcinogenesis. In this respect alternative techniques have been searched preferably lined by urothelium. We performed retroperitoneal ureterocystoplasty in 3 patients with a diagnosis of neurogenic bladder and investigated the clinical and functional aspects. Materials & Methods: Three patients, 2 male and 1 female patients with neurogenic bladder and bilaterally functional kidneys were selected. All the patients were incontinent, had a small-capacity, noncompliant bladder, and high-grade reflux on voiding cystouretrography (VCUG). Urodynamic study was performed in all. Retroperitoneal ureterocystoplasty using distal end of both ureter in 2 patients and one ureter in other patient was performed. Postoperatively all patients were followed with voiding cystourethrography(VCUG) after one month and bladder capacity measured. Results: Median age was 20.3 years (18-22). Preoperative serum creatinine was 2.3, 2.4 and 2.7 mg/dl and preoperative bladder capacity was 100, 70 and 55ml. The operative duration for the procedure was 3, 2.5 and 2.5 hours. The postoperative course was uneventful. Mean hospital stay time was 6.7 days. All patients were dry by day with clean intermittent catheterization. Serum creatinine was 1.2, 1.6 and 1.9 mg/dl one month postoperatively. Bladder capacity was increased to 340, 360 and 290 ml. Conclusions: The early results of ureterocystoplasty compare favourably with those of enterocystoplasty without the risks of long-term metabolic and neoplastic complications. Augmentation ureterocystoplasty has the beneficial effects of enterocystoplasty without the complications that may arise from the use of bowel segments.

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