Reconstruction and undiversion of the short or severely dilated ureter: the antireflux ileal nipple revisited

The Journal of Urology
R Gosalbez, A E Gousse

Abstract

Patients undergoing reconstruction of short or severely dilated aperistaltic ureters are at significant risk for mechanical or functional obstruction and reflux, particularly when the ureters are being reimplanted into gastric or intestinal segments. For this problem we describe a simple handsewn, "stapleless" antireflux ileal nipple, which serves as a useful bridge between a short ureter and the bladder or reservoir. A total of 12 patients, 4 to 42 years old (mean age 19), 9 with severely dilated and 3 with short ureters have received the stapleless antireflux ileal nipple as part of various reconstructive efforts. Briefly, a 12 to 15 cm. segment of ileum is isolated and the mesentery is stripped from the middle 8 cm. of the isolated segment, preserving the blood supply to the proximal and distal 2 cm. of ileum. Intussusception is created and maintained with multiple (5 to 7) circumferential rows of 4 to 6 interrupted seromuscular stitches of 3-zero silk. Mean followup is 27.5 months (range 6 to 60). Upper tract dilatation has stabilized or improved in all patients, deteriorating temporarily in 1 who had distal nipple stenosis. All patients underwent followup video urodynamic studies, which demonstrated no reflux. Nipple relat...Continue Reading

References

Sep 1, 1982·The Journal of Urology·N G KockB M Philipson
Dec 1, 1980·Journal of Pediatric Surgery·W H Hendren
Aug 1, 1994·The Journal of Urology·S HerschornS B Radomski
May 1, 1996·The Journal of Urology·J P SteinD G Skinner
Sep 1, 1996·The Journal of Urology·D A ElmajianD G Skinner
Feb 1, 1955·The Journal of Urology·G I SMITH, F HINMAN
Jun 1, 1958·The Journal of Urology·V A POLITANO, W F LEADBETTER
Apr 1, 1959·The Journal of Urology·R D TURNER, W E GOODWIN

❮ Previous
Next ❯

Citations

Jan 13, 2006·The Journal of Urology·Benjamin I ChungJohn A Libertino
Jun 20, 2000·Current Opinion in Urology·J C Png, C R Chapple
Jun 25, 2021·Journal of Pediatric Urology·T KoszutskiL Hyla-Klekot

❮ Previous
Next ❯

Related Concepts

Related Feeds

Bladder Carcinoma In Situ

Bladder Carcinoma In Situ is a superficial bladder cancer that occurs on the surface layer of the bladder. Discover the latest research on this precancerous condition in this feed.

Related Papers

International Journal of Urology : Official Journal of the Japanese Urological Association
H KatoM A Ghoneim
The Journal of Urology
A A Shokeir, M A Ghoneim
The Urologic Clinics of North America
R M Mattos, J J Smith
The Journal of Urology
Bedeir Ali-el-Dein, M A Ghoneim
© 2022 Meta ULC. All rights reserved