title: Cutaneous tube ureterostomy: a fast and effective method of urinary diversion in emergency situations.
abstract: OBJECTIVE
  To report on a simple and rapid method of urinary diversion. This method was applied successfully in different clinical scenarios when primary reconstruction of the ureters was not possible.
  
  
  METHODS
  The disconnected ureter is catheterized by a feeding tube. The tube is secured with sutures and brought out to the lateral abdominal wall as cutaneous tube ureterostomy (CTU).
  
  
  RESULTS
  This method was applied in three different clinical scenarios: a 40-year-old man who sustained multiple high-velocity gunshots to the pelvis with combined rectal and bladder trigone injuries and massive bleeding from a comminuted pubic fracture. Damage control included colostomy and bilateral CTUs. A 26-year-old woman had transection of the right lower ureter during abdominal hysterectomy. Diagnosis was delayed for 3 weeks when the patient developed sepsis. The right kidney was diverted with a CTU. A 37-year-old male suffered from bladder perforation and hemorrhagic shock. Emergency cystectomy was done and urinary diversion was accomplished with bilateral CTUs. In all cases, effective drainage of the urinary system was achieved with normalization of kidney function.
  
  
  CONCLUSIONS
  When local or systemic conditions preclude definitive repair and damage control surgery is needed, CTU provides fast and effective urinary diversion.
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel.
authors.forename: Tamer
authors.initials: T
authors.lastname: Abdin
authors.affiliation: Department of General surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel.
authors.forename: Gideon
authors.initials: G
authors.lastname: Zamir
authors.affiliation: Department of General surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel.
authors.forename: Alon
authors.initials: A
authors.lastname: Pikarsky
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel.
authors.forename: Ran
authors.initials: R
authors.lastname: Katz
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel.
authors.forename: Ezekiel H
authors.initials: EH
authors.lastname: Landau
authors.affiliation: Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel.
authors.forename: Ofer N
authors.initials: ON
authors.lastname: Gofrit
keywords: Ureter; trauma; tube cutenuous ureterostomy