title: [Long-term results for subcutaneous Detour® prosthesis for ureteral obstruction: experiences of implantation, aftercare and management of complications].
abstract: BACKGROUND
  We present the long-term results of implementation of the Detour® prosthesis as an alternative to established methods of surgical, percutaneous or internal urinary diversion.
  
  
  METHODS
  Between 2004 and 2012 a total of 40 prostheses were implanted in 31 patients (mean age 65 years) with ureteral strictures of various origins. In the follow-up the patients underwent examinations and completed questionnaires.
  
  
  RESULTS
  The average follow-up was 23 months (range 1-92 months). Sonographic examinations showed no urinary retention in 38 out of 40 implanted systems. The retention values were stable in 19 patients, improved in 7 and worse in 3. The quality of life (QoL) was high (EORTC QLQ-C30 90%). Intraoperative complications were 2 intestinal lesions and 3 bleeding of the renal-pelvic system. Postoperative urinary tract infections and wound complications were encountered. In the long-term course three infected hydronephroses occurred which were treated and cured with antibiotics and temporary nephrostomy and 4 systems were explanted, including 2 exchanges.
  
  
  CONCLUSIONS
  The system may be considered for patients with ureteral strictures with palliative and curative intent. There were no significant disadvantages in comparison with established methods. There were fewer risks in implantation and complications were manageable. The quality of life was significantly improved.
authors.affiliation: Universitätsklinik für Urologie und Kinderurologie, Universitätsklinikum Magdeburg A.ö.R., Leipziger Straße 44, 39120 Magdeburg, Deutschland. andreas.janitzky@med.ovgu.de
authors.forename: A
authors.initials: A
authors.lastname: Janitzky
authors.forename: J
authors.initials: J
authors.lastname: Borski
authors.forename: M
authors.initials: M
authors.lastname: Porsch
authors.forename: J J
authors.initials: JJ
authors.lastname: Wendler
authors.forename: D
authors.initials: D
authors.lastname: Baumunk
authors.forename: U-B
authors.initials: UB
authors.lastname: Liehr
authors.forename: M
authors.initials: M
authors.lastname: Schostak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects; D011474:Prosthesis Design; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000175:diagnosis* / Q000628:therapy*; D014547:Urinary Diversion / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*