Editorial Comment

Abstract

Cutaneous ureterostomy is the simplest form of incontinent urinary diversion with an attached urine storage appliance. Despite its procedural simplicity, cutaneous ureterostomy has not been the standard method for incontinent urinary diversion because of stromal stenosis. Thus, several attempts have been made to prevent stenosis.1, 2 Several surgical factors give rise to stromal stenosis: dissection of the ureter to preserve lymphovessels, avoiding excess tension on the ureter, and the formation of the flap or fistulae between the dissected ureter and the skin. In order to overcome these problems, surgeons should continue to deliberate on the anatomical and histological considerations and preoperative design. Without such consideration, high-quality results may not be reproducible. Taking the above problems into consideration, it may be possible to successfully accomplish cutaneous ureterostomy. In this issue Wada et al.3 focus on the importance of the route of the dissected ureter to preserve the fascia between the spermatic cord and the ureter (S-U fascia), with excellent results. Cutaneous ureterostomy is less invasive and feasible; however, many unsolved problems remain.