Korean J Urol.  2012 May;53(5):355-359.

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

• Zilberman
• Golomb J
• Kitrey ND
• Inbar Y
• Heyman Z
• Kleinnbaum Y
• Mor Y

Abstract

PURPOSE
Unilateral 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 METHODS
The 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.
RESULTS
Between 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.
CONCLUSIONS
Unilateral 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.

Keyword

Ureteral reflux; Ureterostomy; Urinary bladder function

MeSH Terms

Follow-Up Studies
Humans
Infant, Newborn
Lower Urinary Tract Symptoms
Retrospective Studies
Ureter
Ureterostomy
Urinary Bladder
Urinary Diversion
Urination

Figure

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  FIG. 1 Unilateral low-loop cutaneous ureterostomy. The drainage of one kidney to the skin is directly achieved through the proximal segment of its associated ureter, whereas the drainage of the contralateral kidney is achieved by urine passage through the bladder and from there via vesico-cutaneous reflux through the distal portion of the diverted ureter.

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