Further experience with staged ureterocolocolostomy urinary diversion.

Disenchantment with the long-term results with ureterosigmoidostomy and ileal loop urinary diversion led to increased use of the nonrefluxing colon conduit. In 1978, we reported our initial experience with 3 adult patients in whom such a diversion was initially performed followed by conversion with an end-to-side colocolostomy achieving a staged nonrefluxing ureterocolocolostomy. We believed that a staged procedure would allow decompression of the upper urinary tract away from the fecal stream, that one could confirm the adequacy of the nonrefluxing tunnels prior to exposure to the fecal stream, and that this might have a lower instance of electrolyte problems and pyelonephritis. Further follow-up on these original 3 patients as well as our experiences with two others, as reported here has somewhat tempered our initial enthusiasm.