Terminal loop cutaneous ureterostomy in renal transplantation: an under utilized urinary diversion technique.
OBJECTIVE
We evaluated the effectiveness of terminal loop cutaneous ureterostomy as a means of urinary drainage in kidney transplant recipients during a 20-year period.


METHODS
Five cadaveric and 2 living related patients underwent kidney transplantation with terminal loop cutaneous ureterostomy between 1984 and 2004. These patients had no usable bladder or they were not suitable candidates for intermittent catheterization.


RESULTS
Followup was 20 months to 17 years. One patient underwent stomal revision 5 months after renal transplantation. Current serum creatinine 4 years later was 166 mumol/l. The remaining 6 patients had no evidence of ureteral obstruction and rarely had bacteriuria or urinary tract infections. Four patients had a functioning allograft with normal serum creatinine. One patient died with a normally functioning allograft and the remaining patient lost his graft due to chronic rejection. No patient in this series lost the graft due to a urological cause. Overall outcomes included excellent allograft function with minimal infection or stomal stenotic complications.


CONCLUSIONS
Terminal loop cutaneous ureterostomy is a simple, safe and alternative means of urinary diversion in patients with renal transplant and a defunctionalized lower urinary tract.
Tsai
Shian Yiu
SY
Division of Urology and Renal Transplantation, Department of Surgery, McMaster Institute of Urology, McMaster University, Hamilton, Ontario, Canada.
Chang
Chiu Yen M
CY
Piercey
Kevin
K
Kapoor
Anil
A
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D014519:Ureterostomy / Q000379:methods*; D014547:Urinary Diversion; D014563:Urodynamics / Q000502:physiology