Korean J Urol.  2013 Mar;54(3):168-171.

Evaluations for Hydronephrosis After the Establishment of Tubeless Cutaneous Ureterostomy

  • 1Department of Urology, Kohka Public Hospital, Kohka, Japan. cj-kim@belle.shiga-med.ac.jp


To investigate hydronephrosis after the establishment of tubeless cutaneous ureterostomy by using our definition of the tubeless condition and our indications for catheter insertion.
Twenty-eight (54 renal units) patients with both establishment of tubeless cutaneous ureterostomy 3 months after surgery and at least 12 months of follow-up were investigated in this study. The 4-grade system was used to evaluate the hydronephrosis. The definition of the tubeless condition in cutaneous ureterostomy was as follows: 1) the catheter stent is not placed in the renal pelvis through the stoma, 2) the grade of hydronephrosis is less than 3, and 3) the kidney is functioning. Indications for catheter insertion after the establishment of tubeless cutaneous ureterostomy were as follows: 1) difficulty in curing acute pyelonephritis by drug treatments, 2) flank pain due to hydronephrosis, or 3) increase in the grade of hydronephrosis.
The follow-up period was 12 to 78 months (average, 40.5+/-22.1 months). After the establishment of tubeless cutaneous ureterostomy, 6 of 54 renal units (11.1%) were eligible for catheter insertion. The catheter insertion was performed in 4 renal units. Another 2 renal units were followed up without intervention, and they gradually became atrophic. The renal functions were preserved in the other 52 renal units.
Our results suggest that our definition of the tubeless condition and our indications for catheter insertion would be useful for the evaluation and management of hydronephrosis after establishment of tubeless cutaneous ureterostomy.


Complications; Ureteral obstruction; Ureterostomy; Urinary bladder neoplasms; Urinary diversion

MeSH Terms

Flank Pain
Follow-Up Studies
Kidney Pelvis
Ureteral Obstruction
Urinary Bladder Neoplasms
Urinary Diversion


  • FIG. 1 Case 1. (A) Abdominal computed tomography revealed a sac protruding through an area of the abdominal wall in proximity to the stoma. (B) The abdominal wall tunnel for the ureters was constructed in the extreme lateral area of the rectus muscle. The arrow shows the abdominal wall tunnel.

  • FIG. 2 Case 2. (A) Abdominal computed tomography (CT) revealed the ureters at the level of the abdominal wall tunnel for the ureters 5 months after surgery. (B) Abdominal CT revealed the obstruction of the ureters at the level of the posterior sheath of the rectus muscle 15 months after surgery. The arrow shows bilateral hydroureters.


1. Williams O, Vereb MJ, Libertino JA. Noncontinent urinary diversion. Urol Clin North Am. 1997. 24:735–744.
2. Hirokawa M, Iwasaki A, Yamazaki A, Asakura S, Nozaki A, Yamagishi T. Improved technique of tubeless cutaneous ureterostomy and results of permanent urinary diversion. Eur Urol. 1989. 16:125–132.
3. Ariyoshi A, Fusijawa Y, Ohshima K, Hiratsuka Y, Sakamoto K. Catheterless cutaneous ureterostomy. J Urol. 1975. 114:533–535.
4. Toyoda Y. A new technique for catheterless cutaneous ureterostomy. J Urol. 1977. 117:276–278.
5. Rainwater LM, Leary FJ, Rife CC. Transureteroureterostomy with cutaneous ureterostomy: a 25-year experience. J Urol. 1991. 146:13–15.
6. Namiki T, Yanagi S. A new technique for bilateral single stoma loop cutaneous ureterostomy. J Urol. 1995. 154(2 Pt 1):361–363.
7. Kim CJ, Wakabayashi Y, Sakano Y, Johnin K, Yoshiki T, Okada Y. Simple technique for improving tubeless cutaneous ureterostomy. Urology. 2005. 65:1221–1225.
8. Straffon RA, Kyle K, Corvalan J. Techniques of cutaneous ureterostomy and results in 51 patients. J Urol. 1970. 103:138–146.
9. Kim CJ, Takimoto K, Tomita K, Osafune T, Nishikawa N, Johnin K, et al. Evaluation of hydronephrosis with tubeless cutaneous ureterostomy using Tc-99m MAG3 diuretic renography. Clin Nucl Med. 2009. 34:666–669.
10. Rodriguez AR, Lockhart A, King J, Wiegand L, Carrion R, Ordorica R, et al. Cutaneous ureterostomy technique for adults and effects of ureteral stenting: an alternative to the ileal conduit. J Urol. 2011. 186:1939–1943.
11. Talner LB. Pollack HM, editor. Obstructive uropathy. Clinical urography. 1990. Philadelphia: W.B. Saunders;1535–1751.
12. McGrath A, Porrett T, Heyman B. Parastomal hernia: an exploration of the risk factors and the implications. Br J Nurs. 2006. 15:317–321.
Full Text Links
  • KJU
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr