A novel technique of ureteroneocystostomy (extravesical seromuscular tunnel): a preliminary clinical study.
OBJECTIVE
To present our initial clinical experience with the new technique of extravesical seromuscular tunnel ureteroneocystostomy.


METHODS
The technique was performed in 21 patients for different indications; the most common was unilateral bilharzial stricture of the lower end of the ureter. The patients were regularly seen every 3 months during the first year, every 6 months during the second year, and annually thereafter during a follow-up period of 24.2 +/- 10.2 months. A chemical profile, urine culture, and renal ultrasound scan were performed at every visit. A technetium-99m diethylenetriaminepentaacetic acid renal scan was carried out at least once every 12 months. Ascending cystography and intravenous urography were done at least once during the entire follow-up period.


RESULTS
The postoperative course was uneventful in all patients. Improvement in renal function was achieved in 16 patients and the remaining 5 experienced stabilization. Improvement of the configuration of the corresponding renoureteral unit was observed in all but 4 patients who had stabilization to almost that of the preoperative condition. None of the 21 patients demonstrated vesicoureteral reflux during the follow-up period.


CONCLUSIONS
The new technique of extravesical seromuscular tunnel is suitable for reimplantation of the dilated ureters. Other studies with a larger number of patients and a longer duration of follow-up are necessary to confirm these results.
Shokeir
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AA
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D003559:Cystostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014546:Urinary Catheterization / Q000379:methods