title: [Technical features of intestinal ureteroplasty. part 5: bilateral ureteroplasty].
abstract: OBJECTIVE
  To present the results and the technical features of the various methods of bilateral ileal ureteroplasty.
  
  
  METHODS
  From 2001 to 2016, 154 patients (mean age 52+/-9.2 years) underwent ileal and appendicular substitution of the ureter and urinary bladder. Study participants comprised 70 (45.4%) men and 84 (54.6%) women. All patients underwent comprehensive examination, including ultrasound, X-ray, radioisotope and endoscopic tests. Bilateral isolated ileal ureteroplasty was performed in 20 patients (40 substituted ureters) whereof in 14, 5 and 1 cases U-shaped, 7-shaped and two separate grafts were used, respectively.
  
  
  RESULTS
  Postoperative complications occurred in 2 (10%) of 20 patients who underwent bilateral intestinal ureteroplasty. Acute small bowel obstruction occurred in a patient after a U-shaped substitution of extended defects of both ureters. He underwent relaparotomy, bypass ileotransverse side-to-side anastomosis. Another patient developed right-sided ureteral-intestinal anastomotic leak following bilateral 7-shaped ureteroplasty. After relaparotomy and right ureter ligation, the breakdown site of the graft was closed with suturing. Repeat operations were successful; there were no deaths.
  
  
  CONCLUSIONS
  Bilateral ileal ureteroplasty is much more complicated surgery than a unilateral operation. For proper collection and preparation of ileal graft in isoperistaltic position without mesenteric torsion, one should know how to place it in relation to intestinal anastomosis. Depending on this, several types of bilateral ileal ureteroplasty may be used: U-shaped, bilateral 7-, J- or L-shaped or separate isoperistaltic ileoureteroplasty.
authors.affiliation: Department of Urology, I.I. Mechnikov North-Western State Medical University.|Multidisciplinary City Hospital 2, Department of Urology.
authors.forename: B K
authors.initials: BK
authors.lastname: Komyakov
authors.affiliation: Department of Urology, I.I. Mechnikov North-Western State Medical University.|Multidisciplinary City Hospital 2, Department of Urology.
authors.forename: V A
authors.initials: VA
authors.lastname: Ochelenko
authors.affiliation: Department of Urology, I.I. Mechnikov North-Western State Medical University.|Multidisciplinary City Hospital 2, Department of Urology.
authors.forename: T Kh
authors.initials: TK
authors.lastname: Al-Attar
authors.affiliation: Department of Urology, I.I. Mechnikov North-Western State Medical University.|Multidisciplinary City Hospital 2, Department of Urology.
authors.forename: A Kh
authors.initials: AK
authors.lastname: Gaziev
mesh_terms: D001065:Appendix / Q000601:surgery / Q000637:transplantation*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery / Q000637:transplantation*; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects
keywords: ileal substitution; stricture; ureter