Long-Term Urinary Bladder Function Following Unilateral Refluxing Low Loop Cutaneous Ureterostomy

Abstract

PurposeUnilateral low loop cutaneous ureterostomy (LLCU) has been offered as the preferred method of temporary urinary diversion in cases of massively dilated and refluxing ureters. We sought to explore whether LLCU is effective in preserving urinary bladder function in the long term.Materials and MethodsThe charts of all patients who had undergone temporary unilateral LLCU as newborns in the presence of massive vesico-ureteric reflux were retrospectively reviewed. Demographic data, follow-up length, and presence of incontinence were recorded. Patients were interviewed regarding lower urinary tract symptoms (LUTS), and their urination patterns were recorded by using uroflow and post-void residual (PVR) measurements.ResultsBetween 1972 and 2003, a total of 24 patients underwent unilateral LLCU in the presence of massively refluxing ureters. Eight patients were included in the final analysis. The median age at diversion was 12 days, the median time to closure was 22.5 months, and the median follow-up was 12.5 years. Urinary bladders showed normal contour, normal capacities, and minimal PVRs in most cases. None of the patients required augmentation cystoplasty. One patient suffered from urinary leakage and few demonstrated minimal LUTS.ConclusionsUnilateral refluxing LLCU is an effective method of urinary diversion that preserves urinary bladder function for the long term. Larger studies are required to confirm this finding.

Differences in the development of autogenous nerves between the upper and lower urinary tract

“…Physiological observations indicate that the bladder and posterior urethra may actively control urine transportation (16,17). Contraction of the bladder and the opening of the posterior urethra are synchronized to guarantee normal urination (18).…”