Implantation of the ureters into the colon

Abstract

RETEROINTESTINAL implantation has become established as of greatest value in the treatment of exstrophy of the bladder and of certain congenital and acquired disturbances of the vesicourethral mechanism in which urinary incontinence has not responded to conservative plastic procedures. In this group are cases of (1) complete epispadias with urinary incontinence, (2) traumat.ic injury of the bladder and the urethra, resulting in such conditions as extensive vesicovaginal fistula, and (3) inflammatory lesions of the bladder, so decreasing its capacity that constant dysuria is present, as in some cases of renal tuberculosis and certain cases of chronic interstitial cystitis. The operation also is used as a preliminary to total cystectomy for very extensive? otherwise inoperable, carcinomas of the bladder. The risk of the operation is dependent on the general condition of the patient, on the degree of infection of the kidneys, and on the degree of obstruction of the ureters, with particular reference to their size; the greater the size of the ureter, the greater is the risk of ureterointestinal implantation. The participants in this symposium. have been asked to discuss certain points, some of which will now be taken up briefly,