Experimental repair of ureters by polyethylene tubing and ureteral and vessel grafts.

Abstract

OCCASIONALLY the surgeon is confronted with the vexing problem of restoring a gap in the ureter. If the defect is extensive, he must be content with a choice of either nephrectomy, cutaneous ureterostomy, uterosigmoidostomy, or ureteroureteral anastomosis. 1 A defect of the distal ureter near the bladder can be reconstructed by utilizing a full-thickness flap of bladder wall fashioned into a tube. 2 Experimentally, segments of the ureter have been successfully bridged by the substitution of a loop of terminal ileum. 3 The transplantation of dog ureters into the duodenum caused death from electrolyte imbalance. 4 Vitallium 5 and fascial transplants 6 have been used as a direct method of reconstructing ureteral defects. Vitallium tubes are reported to be tolerated in the urinary tract of the dog for as long as nine months without causing encrustrations. End-to-end anastomosis of the ureter over a straight Vitallium tube healed per primam in