Ileocecal ureterosigmoidostomy: an alternative to conventional ureterosigmoidostomy.
We describe a 1-stage procedure that involves use of the ileocecal segment as an intervening urine conduit to the large bowel to achieve a continent diversion. The ureters are anastomosed end to end to the terminal ileum that is intussuscepted into the cecum. The cecum then is joined to the lower sigmoid by an end-to-side anastomosis. Mixed urine and feces are eliminated through the rectum. The results in 5 patients with exstrophy and 1 with epispadias between 5 months and 13 years old are reported. Ureteral reflux was not observed. Urinary tract infection developed in 2 patients. Ileocecal ureterosigmoidostomy is a reasonable alternative to intact ureterosigmoidostomy that may reduce the risk of development of cancer.
Kim
K S
KS
Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina.
Susskind
M R
MR
King
L R
LR
D000293:Adolescent; D001746:Bladder Exstrophy / Q000601:surgery; D002648:Child; D012809:Colon, Sigmoid / Q000601:surgery*; D004766:Enterostomy / Q000379:methods; D004842:Epispadias / Q000601:surgery; D005260:Female; D006801:Humans; D007080:Ileocecal Valve / Q000637:transplantation*; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D014547:Urinary Diversion / Q000379:methods*; D014552:Urinary Tract Infections / Q000209:etiology