The Ileal Ureter: Over a Century of Urologic Innovation

Abstract

Objectives Surgical techniques to repair a ureteral stricture may depend on the stricture’s etiology, length, and location. Options may range from primary ureteral reimplantation for short, distal strictures, buccal mucosa onlay ureteroplasty for complex proximal or mid ureteral defects, to Boari flap or even autotransplantation for longer mid to distal ureteral defects. Replacement of the entire ureter with a segment of ileum is rare but may provide durable results when indicated. Our objective was to illustrate how the history and evolution of the ileal ureter entered the contemporary surgical armamentarium. Methods A comprehensive literature review was performed in conjunction with library resources in the History of Medicine section at the University of Rochester. We used PubMed to identify contemporary medical literature, ILLiad to access archived texts and historic surgical and urological textbooks to obtain additional historical information and references. Results We documented perhaps the first description of the ileal ureter in a canine model by Guido Tizzoni and Alfonso Foggi in 1888. Adaptations of ileal ureters over the next century, and beyond, have increased the safety, feasibility, and reproducibility of thre procedure for replacement of the ureter rendered unsalvageable by strictural disease, trauma, or malignancy. Conclusions Tizzoni and Foggi described the first ileal ureter in the canine model in 1888.