Single Stoma Tubeless Cutaneous Ureterostomy: A New Approach to an Old Operation

Abstract

Introduction: Cutaneous ureterostomy is the simplest and safest way for incontinent urinary diversion associated with the lowest rate of early postoperative gastrointestinal and metabolic complications; however, its use is limited because of high rate of stomal stenosis, making ileal conduit the standard method for incontinent urinary diversion.Aim: Present our technique of constructing single site tubeless cutaneous ureterostomy as a valid alternative to ileal conduit.Patients and surgical method: Ten patients underwent the radical cystectomy followed by single stoma tubeless cutaneous ureterostomy. The main differences of our method from previously described techniques were the preservation of parietal peritoneum covering the ureters as a mean for better blood supply preservation and fixation of ureteral orifices one to another forming one oval shaped stoma.Result: One out of ten patients experienced stricture of the stoma meaning requiring a reconstructive surgery on stoma. Other patients were free of obstruction at six month and 12-month period. Conclusion:Cutaneous ureterostomy is a safe method, which is the preferred method of urinary diversion for morbid patients. We believe that modified single stoma tubeless cutaneous ureterostomy could become a method of choice not only for morbid patients but also for patients who are candidates for IC.