A Clinical Review of the Ureteroneocystostomy

Kim, Jae Hyung; Kim, Tai Chin

Abstract

Primary vesicoureteral reflux, distal ureteral obstruction or stricture and injuries are the main indications for the ureteroneocystostomy There are several operative techniques in ureteroneocystostomy and these should be antireflux to preserve renal function. To prevent the reflux, sufficient submucosal length, minimum ureteral manipulation, adequate butters and making the new orifice near the trigone are stressed. We performed ureteroneocystostomy in 19 patients(20 ureters) in last 10 years. We evaluate the preoperative state, operative technique, postoperative course and follow up of these cases and report with the review of the articles Results were 1. 19 cases included 5 VUR, 6 ureteral injuries by transabdominal hysterectomy, 3 bladder tumors involving ureteral orifices, 2 ureteroceles with obstruction and 3 chronic inflammatory strictures. 2. Ureteroneocystostomy were done by Cohen in 4, Glenn-Anderson in 2, Politano-Leadbetter in 3, Boari-Kuss in 5, Paquin in 2 and fish-mouth in 3 cases 3. Ureteral stent and suprapubic cystostomy were made in all cases but one. Duration of stenting was 4-14 days and cystostomy was 6-14 days. 4. There were improvements in 16 cases, but failed in 2 ureters of reflux cases.