Experimental evaluation of three types of end-to-end ureteroureteral anastomosis

Abstract

1.1. The distal end of the right canine ureter was partially obstructed by a tantalum clamp to increase its diameter to approximate that of the human ureter.2.2. Ten to fourteen days later the clamp was removed and the now enlarged ureter was divided 2 to 3 cm. proximal to the site of clamping. The ends were reunited end to end by one of three ways.3.3. In Type I, the ureteral ends were apposed by No. 5-0 chromic catgut sutures, mostly extraurothelial, 1 mm. apart.4.4. In Type II, the ends were apposed on a fine polyethylene splint by two to four through-and-through No. 5-0 chromic sutures. The splint was removed after three to four weeks and the dogs sacrificed one to two months later.5.5. In Type III, the ends were apposed over a fine polyethylene splint by No. 5-0 chromic sutures, mostly extraurothelial, 1 mm. apart. The splint was removed after three to four weeks and the dogs sacrificed four to six weeks later.6.6. Using extent of muscular apposition and freedom from stenosis as criteria, Type III excelled. Results of Type I were very good and of Type II moderate. None of the animals died and none showed drainage through the incision. The ureters were equally dilated distal and proximal to the anastomosis.7.7. The splint did not produce intraluminal growth or stricture where it formed contact with the ureter at its free proximal end.