title: [Technical features of intestinal ureteroplasty. art 6: simultaneous ureteral and bladder substitution].
abstract: OBJECTIVE
  To present the results and technical features of different methods of simultaneous ileal ureteral and bladder substitution.
  
  
  METHODS
  From 2001 to 2016, 154 patients (mean age 52+/-9.2 years) underwent ileal and appendicular ureteroplasty. Of them, 70 (45.4%) were men and 84 (54.6%) women. Among them, 49 (31.8%) patients underwent ureteroplasty concurrently with orthotopic ileocystoplasty. The Studers ileal-ureter cystoplasty and Y-shaped bladder and ureteral reconstruction were performed in 38 (77.5%) and 11 (24.5%) cases, respectively.
  
  
  RESULTS
  Early postoperative complications occurred in 8 (16.3%) patients: 4 of them suffered recurrent bouts of pyelonephritis, 3 experienced an acute adhesive intestinal obstruction, and another one had a failure the right-sided pouch-ureteral anastomosis. Late postoperative complications occurred in 7 (14.3%) patients. Of them, 3 suffered recurrent bouts of chronic pyelonephritis, 2 developed a pouch-ureteral-pelvic reflux, and 2 had strictures of ileoureteral anastomosis, requiring antegrade dilation with ureteral stenting.
  
  
  CONCLUSIONS
  Simultaneous ureteral and bladder substitution is one of the most challenging and traumatic surgical interventions. Sometimes, due to severe comorbidities, disorders of upper tract urodynamics and decreased renal function, two-stage surgery may be necessary. At the first stage, cystectomy with cutaneous ureterostomy should be performed, and then, after the patients stabilization ileal substitution of the bladder and pelvic parts of ureters may be done.
authors.affiliation: Department of Urology, I.I. Mechnikov North-Western State Medical University, Multidisciplinary City Hospital 2, Department of Urology, St. Petersburg, Russia.
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, St. Petersburg, Russia.
authors.forename: A I
authors.initials: AI
authors.lastname: Novikov
authors.affiliation: Department of Urology, I.I. Mechnikov North-Western State Medical University, Multidisciplinary City Hospital 2, Department of Urology, St. Petersburg, Russia.
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, St. Petersburg, Russia.
authors.forename: B G
authors.initials: BG
authors.lastname: Guliev
authors.affiliation: Department of Urology, I.I. Mechnikov North-Western State Medical University, Multidisciplinary City Hospital 2, Department of Urology, St. Petersburg, Russia.
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, St. Petersburg, Russia.
authors.forename: M V
authors.initials: MV
authors.lastname: Onoshko
mesh_terms: D015653:Cystectomy; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D014513:Ureter / Q000601:surgery*; D014515:Ureteral Diseases / Q000150:complications / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000150:complications / Q000601:surgery
keywords: ileal substitution; ureter stricture