Cutaneous Ureterostomy in Children-Long-Term Followup

Abstract

From 1963 to 1983, 45 children with benign disease underwent urinary diversion with cutaneous ureterostomy. Patient selection for cutaneous ureterostomy was predicted on the presence of at least 1 dilated ureter. Followup ranged from 4 months to 20 years, with a mean of 7.9 years. Of the patients 29 (64 per cent) had a minimum followup of 5 years and 18 (40 per cent) were followed for more than 10 years. Postoperative complications, results of followup excretory urography and the ultimate fate of these children were analyzed. The results demonstrate the usefulness of cutaneous ureterostomy as a permanent form of urinary diversion in selected children.

Double-J stent insertion across vesicoureteral junction—is it a valuable initial approach in neonates and infants with severe primary nonrefluxing megaureter?

“…Temporization has classically been achieved by external urinary diversion by way of nephrostomy tubes or cutaneous ureterostomy. 3,4 Both methods, however, are cumbersome, prone to complications, difficult to handle, and not well accepted by parents. Internal drainage is theoretically a better option.…”

“…In these cases, diversion can be considered appropriate to postpone definitive treatment until after 1 year of age and/or allow accurate assessment of renal function before embarking on major bladder reconstruction. [3][4][5] External urinary diversion is a well-established temporizing measure in children with urinary tract obstruction. However, both nephrostomy tubes and cutaneous ureterostomy have their limitations, and methods for internal drainage would be preferable.…”

“…However, both nephrostomy tubes and cutaneous ureterostomy have their limitations, and methods for internal drainage would be preferable. 3,4 Lee et al 5 have recently suggested creation of a refluxing reimplantation as an internal diversion method according to the principle that surgery can be safely deferred if vesicoureteral junction (VUJ) obstruction is exchanged for the less harmful vesicoureteral reflux (VUR). 5 Double-J stent insertion across the VUJ is potentially a minimally invasive alternative to achieve temporary internal drainage of PNRMs.…”

Transureteropyeloureterocutaneostomy

“…The param- sionary conduits are a logical alternative. With the TUUC described in 1958 by Obrant [ 1 ], both the surgical compli cations and the results of diversionary conduits are less at least in the short and medium term [11][12][13][14], However, their main problem (stoma stenosis) can be definitively avoided neither with the numerous ureteral and/or cuta neous grafts, nor with an implantable plastic prosthesis [15][16][17], Whenever necessary, only one of the two ureters may be intubated (e.g. with a double-J catheter), but the other may be obstructed by this.…”

Y-Ureterokutaneostomie bei angeborenem Hydroureter - eine kausale Therapie?

“…Bei 1/5 der Fälle haben wir einen Spontanverschluß des Stomas erleben müssen, bei einern weiteren Fünftel mußte der Stenosierungstendenz durch mehrmalige Bougierung entgegengewirkt werden. Auch diese Komplikationsrate ist in der Literatur ähnlich (2,3,4). Vergleicht man die Y-Ureterokutaneostornie mit der Nephrostomie, so zeigt sich, daß die perkutane Nephrostomie ein komplikationsarmer Eingriff mit einer guten Entlastung der Niere darstellt (1, 6).…”