Standard Reconstruction Techniques: Techniques of Ureteroneocystostomy During Urinary Diversion

Abstract

The principles of ureteric reconstruction during urinary diversion are not dissimilar from other reconstructive techniques used in the rest of the urinary tract. Excellent vascular supply, complete excision of devitalized tissue, good drainage, and a tension-free anastomosis are of paramount importance. Various operative procedures have been described for replacement of the bladder after cystectomy or in conditions with severe bladder dysfunction (eg, in patients with neuropathic bladder). An important requirement after reconstruction of the lower urinary tract, such as with an ileal conduit or orthotopic bladder substitution, is that the reconstruction should not jeopardize the integrity of the upper urinary tract. The development of partial or complete obstruction of urine flow, the reflux of infected urine, and the formation of renal stones are factors that may adversely affect renal function.