Chitale S V, Chitale V R
Department of Surgery, Dr. V. M. Medical College, General Hospital, Solapur, 413001, Maharashtra, India.
World J Urol. 2006 Jun;24(2):220-3. doi: 10.1007/s00345-006-0080-4. Epub 2006 Apr 22.
Ileal conduit and orthotopic bladder substitution have been the preferred options for urinary diversion after cystectomy. Self-catheterisation has revolutionised the management of neuropathic bladder. However, ureterocutaneostomy (cutaneous ureterostomy) described as a means of supravesical urinary diversion 40 years ago still has a definite role for both temporary and permanent diversion particularly in the developing countries. We present a small series of cutaneous ureterostomies performed in four children who have now grown up to become adults without being undiverted. We discuss the technique that we used to modify the stoma, which helped prevent stomal complications over the long term. Our results we believe will rekindle the interest in cutaneous ureterostomy as a viable option for permanent urinary diversion. Four children between ages 2 and 16 years had bilateral side-to-side single stoma tubeless end cutaneous ureterostomy as a primary procedure for permanent urinary diversion. The stoma was modified to prevent retraction and stenosis. Long-term follow-up is presented. All the children have grown up to become adults with their ureterocutaneostomies functioning very well. There have been no biochemical or mechanical complications. Only one out of four stomas had to be refashioned. A simple collection device has proved successful in maintaining a watertight drainage system without apparent problems. Bilateral side-to-side single stoma end cutaneous ureterostomy with modification of the stoma by a plastic surgical technique can help achieve a non-retracting stoma on which a collection device can snuggly fit. It is a viable option for permanent urinary diversion without any significant complications. It is simple, easy and highly practical way of managing urinary diversion especially in the developing countries.
回肠代膀胱术和原位膀胱替代术一直是膀胱切除术后尿流改道的首选方法。自我导尿彻底改变了神经源性膀胱的治疗方式。然而，40年前被描述为一种膀胱上尿流改道方法的输尿管皮肤造口术（皮肤输尿管造口术），在临时和永久性尿流改道中仍具有明确作用，尤其是在发展中国家。我们报告了一小系列在4名儿童中实施的皮肤输尿管造口术，这些儿童现已长大成人，尿流改道仍未改变。我们讨论了用于改良造口的技术，该技术有助于长期预防造口并发症。我们相信我们的结果将重新激发人们对皮肤输尿管造口术作为永久性尿流改道可行选择的兴趣。4名年龄在2至16岁之间的儿童接受了双侧并排单造口无管端端皮肤输尿管造口术，作为永久性尿流改道的主要手术。对造口进行了改良以防止回缩和狭窄。现给出长期随访情况。所有儿童均已长大成人，其输尿管皮肤造口术功能良好。未出现生化或机械性并发症。4个造口中只有1个需要重新整形。一种简单的收集装置已被证明成功维持了防水引流系统，且无明显问题。通过整形手术技术改良造口的双侧并排单造口端端皮肤输尿管造口术，有助于实现一个收集装置能够紧密贴合的无回缩造口。它是永久性尿流改道的可行选择，且无任何重大并发症。它是管理尿流改道的一种简单、易行且高度实用的方法，尤其是在发展中国家。
