title: Clinical benefits of tubeless umbilical cutaneous ureterostomy.
abstract: BACKGROUND
  We assess a novel technique of tubeless bilateral cutaneous ureterostomy, with a single umbilical stoma, for bladder cancer patients with short ureters after cystectomy. The benefit of cutaneous ureterostomy is equal to other incontinent urinary diversions, when the tubeless procedure is successfully achieved. This simple technique makes it easy to monitor the upper urinary tract (UUT) and is beneficial to patients with a high risk of UUT recurrence.
  
  
  METHODS
  This old and new surgical technique was used to perform total cystectomy and urinary diversion on three patients with bladder cancer at a high risk of UUT recurrence.
  
  
  RESULTS
  Two men and one woman (mean age: 73 years) underwent this surgery and the mean follow-up period was 8.3 years. The surgical approaches were laparotomy (n = 2) and laparoscopy (n = 1). One case developed para-stomal erosion, whereas another developed ureteral stenosis requiring catheter reinsertion. Although postoperative hydronephrosis was observed in all cases, the mean preoperative and postoperative serum creatinine levels were 0.70 and 0.76, respectively. UUT recurrence was not observed during the follow-up period.
  
  
  CONCLUSIONS
  This tubeless umbilical cutaneous ureterostomy procedure greatly improves the outcome of urinary diversion for cancer patients with short ureters at a high risk of UUT recurrence. The benefits are equivalent to other urinary diversions when the tubeless procedure is successfully achieved.
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Numakura
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Norihiko
authors.initials: N
authors.lastname: Tsuchiya
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Makoto
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsuruta
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Susumu
authors.initials: S
authors.lastname: Akihama
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Saito
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Shintaro
authors.initials: S
authors.lastname: Narita
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Mingguo
authors.initials: M
authors.lastname: Huang
authors.affiliation: Center for Kidney Disease and Transplantation, Akita University Hospital, Atika City, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Satoh
authors.affiliation: Department of Urology, Akita University Graduate School of Medicine, Akita City, Japan;
authors.forename: Tomonori
authors.initials: T
authors.lastname: Habuchi