Abstract
Introduction: Cutaneous ureterostomy is the simplest and safest way for incontinent urinary diversion associated with the lowest rate of early postoperative gastrointestinal and metabolic complications; however, its use is limited because of high rate of stomal stenosis, making ileal conduit the standard method for incontinent urinary diversion.
Highlights
Cutaneous ureterostomy is the simplest and safest way for incontinent urinary diversion associated with the lowest rate of early postoperative gastrointestinal and metabolic complications; its use is limited because of high rate of stomal stenosis, making ileal conduit the standard method for incontinent urinary diversion
Cutaneous ureterostomy is a safe method, which is the preferred method of urinary diversion for morbid patients
We believe that modified single stoma tubeless cutaneous ureterostomy could become a method of choice for morbid patients and for patients who are candidates for ileal conduit (IC)
Summary
It has been reported that at the time of the diagnosis 30% of bladder cancers are already muscle invasive for which the treatment includes surgery and/or chemotherapy and/or radiation therapy. Anterior and posterior rectus muscle sheaths are sutured together to fix the tunnel length. Both ureters together with preserved parietal peritoneum are pulled through without tension and distortion at least 1.5-2cm above skin level. The left ureter is directed to the right side via a retroperitoneal cavity above the mesenteric inferior artery Both of the ureters are brought through in a completely extra peritoneal manner in all patients (Figure 2). Oval shape ureters are fixed with 6-8 interrupted 5-0 PGA sutures to the aponeurosis and epidermis adapting everted cutaneous ureterostomy (Figure 8 & 9). In total 10 patients underwent modified technique of single stoma cutaneous ureterostomy in 2016.
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