[Choice criteria and complications of urinary diversions].
The choice of urinary diversion is conditioned to patient's disease, performance status, age and life style. Ureterointestinal anastomosis is a critical stage in urinary diversion, allowing urinary transit and preventing reflux. We have examined urinary diversion frequently used in our clinical practice. In ureterosigmoidostomy and MAINZ pouch II , ureterointestinal anastomosis isn't refluent. Ileal conduit, reserved to patient with advanced disease and/or low life expectation, normally the implantation is direct. In continent reservoir and orthotopic neobladder, detubularization produces low pressure. In these urinary diversion anti-reflux anastomosis isn't mandatory, because the risk of stenosis is higher. Urinary infection is an important criterion in choice of anastomosis. After all is emphasized that success of ureterointestinal implantation doesn't depend on surgeon's level of experience.
Unita Operativa Urologia, Ospedali Riuniti, Bergamo, Italy. aranieri@ospedaliriuniti.bergamo.it
Antonio
A
Ranieri
Emanuele
E
Micheli
Graziano
G
Zanardi
Antonio
A
Lembo
D003106:Colon / Q000601:surgery; D012809:Colon, Sigmoid / Q000601:surgery; D003251:Constriction, Pathologic / Q000209:etiology; D004108:Dilatation, Pathologic / Q000209:etiology; D006801:Humans; D011183:Postoperative Complications; D012086:Reoperation; D014519:Ureterostomy; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods; D014552:Urinary Tract Infections / Q000209:etiology