Function of Kidneys and Urinary Tract in Patients with Ileal Ureter


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Abstract

Relevance Treatment of patients with extended ureteral strictures remains the important problem of reconstructive urology. Intestinal ureteral substitution is the operation of choice and reliable last resort in such patients. However the main for the surgeon criteria of efficiency of treatment – the long-term results, are studied insufficiently.

The purpose of the study To evaluate the function of kidneys and upper urinary tract in 47 patients, underwent ureteral substitutions with ileum.

Materials and methods From 2001 to 2012 47 patients underwent ileal ureter replacement. There were 34 women and 13 men with a median age of 46,3±9,3 years (range from 18 to 69 years). In 33 (70,2%) cases ureteral defects were unilateral, and in 14 (29,8%) bilateral. The main causes of ureteral strictures were: retroperitoneal fibrosis following radiation therapy, colorectal and gynecological cancer surgery. Results and their discussion The follow up period was from 3 months up to 11 years (mean 6,8±1,2 years). Postoperative complications developed in 7 (14,9%) cases. Short-term complications  occurred in 6 (12,8%) patients and late complication – stricture of ileal graft anastomosis developed in 1 patient (2,1%). Thus, the complications which have required surgical treatment occurred at 3 (6,4%) patients.

The results of all operations were successful. According to all patients the renal function was restored.

Conclusion Intestinal ureteral substitution is a efficacious procedure and reliable last resort in patients with extended ureteral strictures.  This operation is an alternative intervention to nephrectomy. It provides good long-term functional results and allows to preserve the kidney function.

About the authors

North-West State Medical University of I.I.Mechnikov, St. Petersburg, Russian Federation

Author for correspondence.
Email: ochelenko-v@yandex.ru
candidate of Medicine, Assistant Professor Department of Urology of the northWestern State Medical University. Mechnikov

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