[Clinical study on ureterosigmoidostomy].

Clinical studies were made of 60 patients who had undergone ureterosigmoidostomy at our department. The 45 men and 15 women ranged from 35 to 73 years old, with a mean of 59.2 years. Ureterosigmoidanastomosis was performed using the modified Coffey II technique in this series. Bladder tumor was the reason for the operation in 55 cases, uterine cancer in 2, contracted bladder in 1, vesicovaginal fistula in 1 and urethral stricture in 1. In the excretory pyelogram one month after the operation, normal findings and slight hydronephrosis were observed in 37% and 63% of the patients, respectively. However, the pyelogram 6 months after the operation demonstrated normal findings in 61% of the patients, slight hydronephrosis in 34% and moderate hydronephrosis in 5%. None of them showed severe hydronephrosis. Slightly increased BUN level (less than 30 mg/dl) was seen in 15 out of 45 patients (32%) at one year after ureterosigmoidostomy. However, serum creatinine level was not above normal throughout the postoperative course. Although postoperative hyperchloremia was appreciably detected, it was easily managed by the administration of sodium bicarbonate. Serum sodium and potassium levels remained stationary. Of 35 patients observed for more than one year after operation, 11 patients (31%) had developed fever due probably to pyelonephritis, but sigmoidography failed to demonstrate any ureteral reflux. Either urinary or fecal fistula, a complication in the early postoperative period, occurred in 10 patients (17%). One of these patients died. Five patients were cured by conservative treatment. The remaining 4 patients underwent surgical treatment that was ureterocutaneostomy , nephrectomy, or colostomy.(ABSTRACT TRUNCATED AT 250 WORDS)