title: A deserosalized muscle layer covering method for antireflux ureteroileostomy: a preliminary clinical trial.
abstract: OBJECTIVE
  To achieve complete protection of the upper urinary tract in patients with a neobladder we designed and clinically applied the deserosalized muscle layer covering method, a new antireflux ureteroileal reimplantation technique in which the terminal ureter is implanted in the muscle layer of the ileum. We present the operative procedure and preliminary results.
  
  
  METHODS
  We created an orthotopic ileal neobladder after radical cystectomy in 5 patients with invasive bladder cancer. The ureters were reimplanted into the reservoir using the deserosalized muscle layer covering method. The functional outcome of this procedure was evaluated by radiological studies.
  
  
  RESULTS
  No patients died during the perioperative period and no reimplanted ureters showed ureteral reflux or ureteral stricture during the observation period. Video cystometrograms demonstrated the complete prevention of reflux during the voiding and storage phases.
  
  
  CONCLUSIONS
  The deserosalized muscle layer covering method provided a nonobstructed unidirectional flow of urine in all renal units examined in this study. The efficacy of this method was proved during short-term followup.
authors.affiliation: Department of Urology, Jichi Medical School, Tochigi, Japan.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Shioji
authors.forename: Osamu
authors.initials: O
authors.lastname: Muraishi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tokue
mesh_terms: D015653:Cystectomy / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D009130:Muscle, Smooth / Q000601:surgery; D011183:Postoperative Complications; D014513:Ureter / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent; D014567:Urography