Use of Ileum as Ureteral Replacement in Urological Reconstruction

Sandra A. Armatys, Matthew J. Mellon, Stephen D.W. Beck, Michael O. Koch, Richard S. Foster, Richard Bihrle

Research output: Contribution to journalArticle

82 Scopus citations

Abstract

Purpose: We reviewed indications and outcomes in patients undergoing ileal ureter replacement for ureteral reconstruction. Materials and Methods: Between December 1989 and September 2007, 105 patients underwent ileal ureter replacement, of whom 14 were excluded from study due to incomplete data. The remaining 91 patients (99 renal units) comprised the study cohort. Results: Mean patient age was 46.8 years and mean followup was 36.0 months. Indications for an ileal ureter were stricture following genitourinary surgery in 29 cases (31.9%), radiation induced stricture in 17 (18.7%), nonurological surgery iatrogenic injury in 16 (17.6%) and retroperitoneal fibrosis in 11 (12.1%). Only 4 patients (4.4%) had primary ureteral cancer. Long-term complications included anastomotic stricture in 3 patients (3.3%) and fistula in 6 (6.6%). Serum creatinine decreased or remained stable in 68 patients (74.7%) and hyperchloremic metabolic acidosis developed in 3. No patient complained of excessive urinary mucous production. Conclusions: In 68.1% of patients indications for an ileal ureter included radiation induced stricture or iatrogenic injury. The ileal ureter is a reasonable option for long-term ureteral reconstruction with preserved renal function in carefully selected patients.

Original languageEnglish (US)
Pages (from-to)177-181
Number of pages5
JournalJournal of Urology
Volume181
Issue number1
DOIs
StatePublished - Jan 1 2009

Keywords

  • iatrogenic disease
  • ileum
  • reconstructive surgical procedures
  • ureter

ASJC Scopus subject areas

  • Urology

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