External-internal nephro-uretero-ileal stents in patients with an ileal conduit: long-term results.
OBJECTIVE
To describe an improved technique for upper urinary tract drainage in patients with ureteroileal anastomotic stricture after radical cystectomy and urinary diversion to an ileal conduit, and to review our experience and long-term results.


METHODS
From 1995 to 2002, 16 patients (18 renal units) with ureteroileal anastomotic stricture after radical cystectomy and urinary diversion to an ileal conduit underwent external-internal nephro-uretero-ileal stent placement. The procedure consisted of three stages: insertion of a percutaneous nephrostomy tube; retrograde external-internal stent placement with the help of an antegrade-inserted wire, leaving the stent's port in the stoma bag; and periodic retrograde stent exchange. The median duration of follow-up was 26.6 months.


RESULTS
The overall success rate was 94.7%. No serious complications occurred during the procedure or during follow-up. Patient compliance was fairly good. In 75% of the patients, the stent served as the definitive treatment, avoiding the need for surgical revision.


CONCLUSIONS
External-internal nephro-uretero-ileal stent placement can be used successfully and safely as a definitive treatment for anastomosis-related complications in patients after radical cystectomy and urinary diversion to an ileal conduit.
Tal
Raanan
R
Institute of Urology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
Bachar
Gil N
GN
Baniel
Jack
J
Belenky
Alexander
A
D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic; D015653:Cystectomy; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation; D010349:Patient Compliance; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D014546:Urinary Catheterization; D014547:Urinary Diversion