End Cutaneous Ureterostomy for the Management of Severe Hydronephrosis

Marcello Cimador, Enrico De Grazia, Andrew Mcgregor, David M. Kitchens, William Defoor, Eugene Minevich, Curtis Sheldon, Pramod Reddy, Ethan Polsky, Marina Castagnetti

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Abstract

Purpose: Although rarely indicated, surgical treatment of severe megaureter can pose a formidable technical challenge,especially in the small infant. We present our experience and outcomes with end cutaneous ureterostomy as a temporizingadjunct to future ureteral reimplantation.Materials and Methods: We performed a retrospective cohort study of patients who underwent end cutaneous ureterostomybetween 1993 and 2005. Patient demographics, surgical details and outcomes were recorded.Results: A total of 29 patients (22 males, 7 females) underwent diversion of 34 renal units. Primary megaureter wasdiagnosed in 15 patients (17 renal units). Secondary megaureter was found in 10 patients (12 renal units). Postoperativemegaureter was diagnosed in 4 patients (5 renal units). Mean patient age at time of diversion was 3.2 months for those withprimary megaureter and 1.4 years overall. Bilateral diversion or diversion of a solitary functioning kidney was performed in14 patients (48%), of whom 4 had renal insufficiency. Nine patients (31%) had a febrile urinary tract infection while awaitingundiversion, with no evidence of renal scarring on followup. Undiversion was performed in 12 patients (13 renal units) withprimary megaureter at a mean age of 18 months. Overall, undiversion was performed in 21 patients (23 renal units), andureteral tailoring was required in only 5 renal units (22%). Mean followup after undiversion was 4.2 years for primarymegaureter and 3.9 years overall.Conclusions: End cutaneous ureterostomy is a safe and effective procedure to temporize massive hydronephrosis whileawaiting definitive ureteral reimplantation.
Original languageEnglish
Pages (from-to)1501-1504
Number of pages4
JournalTHE JOURNAL OF UROLOGY
Volume177
Publication statusPublished - 2007

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All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Cimador, M., De Grazia, E., Mcgregor, A., Kitchens, D. M., Defoor, W., Minevich, E., Sheldon, C., Reddy, P., Polsky, E., & Castagnetti, M. (2007). End Cutaneous Ureterostomy for the Management of Severe Hydronephrosis. THE JOURNAL OF UROLOGY, 177, 1501-1504.