EXTENSIVE SCHISTOSOMIASIS OF THE URETER: The use of the ileal loop in its management

Abstract

SUMMARY Four cases of extensive schistosomiasis of the ureter are presented, 3 unilateral and 1 bilateral, in which, after ureterectomy, urinary tract continuity was restored using an isolated loop of terminal ileum. Factors which have emerged as a result of experience with this procedure in these cases, are discussed.

Appendix Ureteroplasty

“…There is little doubt that ileal loop replacement is the method of choice in extensive ureterectomy for schistomosomal strictures Weinberg (1970). However, a s Hovnanian (1972) has suggested, the odd case may arise where the use of the appendix may prove to be suitable because of its anatomical arrangement as in the present case.…”

Pyelo-Ileostomy and Pyelo-Ileo-Cystostomy

“…In our second case, in which pyelo-ileo-cysto-cutaneous anastomosis had been performed as the first stage, temporary occlusion of the cutaneous ileostomy enabled us to pre-test the efficiency of the ureteral bypass before deciding whether to excise the ileostomy. In the 2 cases operated on in our department, the ileal loop was placed isoperistaltically, although if this should endanger the vascular supply of the loop, it can function adequately when placed in an antiperistaltic direction, as was done in one of the cases described by Weinberg (1970). It should be noted that repeated examination of these 3 patients in our medical department revealed no metabolic calculogenic aetiology.…”

“…A third patient who underwent pyelo-ileo-cystostoiny elsewhere has been under our observation for the last 8 years. Weinberg, 1970).…”