Modified technique for urinary diversion with incontinent conduits.
BACKGROUND
Incontinent urinary diversions are frequently performed in gynecologic oncology. The incontinent urinary diversions generally utilize a short segment of distal ileum or colon as a conduit. Conduit complications such as anastomosis leaks and strictures may be related to the technique utilized for inserting and securing the ureters and the degree of postimplant manipulation.


METHODS
We describe a technique using a metal Yankaur suction device placed through the conduit's matured stoma to facilitate the mucosa-to-mucosa anastomosis of the ureters. This procedure allows for tension-free ureteral anastomoses, the isolation of the ideal conduit length, optimal stomal maturation, and reduced manipulation of the conduit after the ureteral anastomoses.


CONCLUSIONS
This modification provides an elegant, yet simple and expedient, method of ureteral anastomosis to the incontinent urinary conduit.
Winter
William E
WE
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Walter Reed Army Medical Center, 6900 Georgia Avenue NW, Washington, DC 20307, USA.
Krivak
Thomas C
TC
Maxwell
G Larry
GL
Elkas
John C
JC
Rose
G Scott
GS
Carlson
Jay W
JW
D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D014513:Ureter / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*