Ureterocutaneostomy: for whom and when?

OBJECTIVE

To discuss the indications and the results of the patients treated with ureterocutaneostomy (UCN) for urinary diversion in our center.

MATERIAL AND METHODS

Between March 2008 and November 2012, 27 patients (19 males and 8 females) were treated with UCN in our clinic. Patients' ages ranged between 56-78 years. Radical cystectomy was performed on 21 of these patients. The patients underwent transureteroureterostomy and UCN or unilateral or bilateral side-by-side UCN on the abdominal wall. Double-J stents were placed inside the ureters and changed every 12 weeks. Comorbidities and American Society of Anesthesiologists (ASA) scores were noted.

RESULTS

The patients had invasive bladder cancer (n=24), multiple tumors within and outside of a diverticulum and intractable recurrent bleeding (n=1), recurrent hemorrhage (n=1), and bladder contracture (n=1). As comorbidities, hypertension (n=14), chronic obstructive pulmonary disease (n=11), diabetes mellitus (n=10), coronary artery disease (n=8), chronic renal failure (n=1), and Crohn's disease (n=1) were detected. The ASA score was 3 or greater in 14 patients. During follow-up period, 3 patients experienced pyelonephritis, and one of them had a strictured ureteral orifice.

CONCLUSION

UCN can be used as a method of urinary diversion in selected patients.