Use of ileum as ureteral replacement in urological reconstruction.
OBJECTIVE
We reviewed indications and outcomes in patients undergoing ileal ureter replacement for ureteral reconstruction.


METHODS
Between December 1989 and September 2007, 105 patients underwent ileal ureter replacement, of whom 14 were excluded from study due to incomplete data. The remaining 91 patients (99 renal units) comprised the study cohort.


RESULTS
Mean patient age was 46.8 years and mean followup was 36.0 months. Indications for an ileal ureter were stricture following genitourinary surgery in 29 cases (31.9%), radiation induced stricture in 17 (18.7%), nonurological surgery iatrogenic injury in 16 (17.6%) and retroperitoneal fibrosis in 11 (12.1%). Only 4 patients (4.4%) had primary ureteral cancer. Long-term complications included anastomotic stricture in 3 patients (3.3%) and fistula in 6 (6.6%). Serum creatinine decreased or remained stable in 68 patients (74.7%) and hyperchloremic metabolic acidosis developed in 3. No patient complained of excessive urinary mucous production.


CONCLUSIONS
In 68.1% of patients indications for an ileal ureter included radiation induced stricture or iatrogenic injury. The ileal ureter is a reasonable option for long-term ureteral reconstruction with preserved renal function in carefully selected patients.
Armatys
Sandra A
SA
Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Mellon
Matthew J
MJ
Beck
Stephen D W
SD
Koch
Michael O
MO
Foster
Richard S
RS
Bihrle
Richard
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D008875:Middle Aged; D012189:Retrospective Studies; D014513:Ureter / Q000293:injuries* / Q000601:surgery*; D014515:Ureteral Diseases / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult