A novel technique of ureteroneocystostomy (extravesical seromuscular tunnel): a preliminary clinical study.

摘要

OBJECTIVES: To present our initial clinical experience with the new technique of extravesical seromuscular tunnel ureteroneocystostomy. METHODS: The technique was performed in 21 patients for different indications; the most common was unilateral bilharzial stricture of the lower end of the ureter. The patients were regularly seen every 3 months during the first year, every 6 months during the second year, and annually thereafter during a follow-up period of 24.2 +/- 10.2 months. A chemical profile, urine culture, and renal ultrasound scan were performed at every visit. A technetium-99m diethylenetriaminepentaacetic acid renal scan was carried out at least once every 12 months. Ascending cystography and intravenous urography were done at least once during the entire follow-up period. RESULTS: The postoperative course was uneventful in all patients. Improvement in renal function was achieved in 16 patients and the remaining 5 experienced stabilization. Improvement of the configuration of the corresponding renoureteral unit was observed in all but 4 patients who had stabilization to almost that of the preoperative condition. None of the 21 patients demonstrated vesicoureteral reflux during the follow-up period. CONCLUSIONS: The new technique of extravesical seromuscular tunnel is suitable for reimplantation of the dilated ureters. Other studies with a larger number of patients and a longer duration of follow-up are necessary to confirm these results.