Urinary diversions: our experience and selection approach

• Published in: Actas urologicas españolas Vol. 15; no. 2; p. 163
• Main Authors: Armora Mani, J, Muñoz Segui, J, Aguiló Lucia, F, Franco Miranda, E, Pérez Céspedes, M, López Costea, M A, Serrallach Mila, N
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.03.1991
• Subjects: Adolescent; Adult; Aged; Child; Colon, Sigmoid - surgery; Contraindications; Evaluation Studies as Topic; Female; Humans; Ileum - surgery; Male; Middle Aged; Reoperation; Retrospective Studies; Ureterostomy; Urinary Bladder Neoplasms - surgery; Urinary Diversion - adverse effects; Urinary Diversion - methods; Urinary Diversion - psychology
• ISSN: 0210-4806; 1699-7980

Retrospective review of 126 urinary by-passes performed in our service over the last 15 years where efficacy and complications arisen from the ureteroileal by-passes, ureterosigmoidostomy and skin ureterostomy are analyzed. Patients were found to be pre-operatively homogeneous with no statistically significant differences with regard to age, renal function or previous radiotherapy, except in the case of ureterostomies which are always initiated from a poorer renal function and general condition. It was concluded that there was no difference between the various Bricker types according to the anastomosis, which allows joint a comparison with other groups. After three months, Bricker's showed better radiologic evolution than Goodwin's (p less than 0.08) and a statistically lower number of complication (p less than 0.05) therefore establishing they should be the choice procedure versus any other type of by-pass. Literature review with regard to results and conditions of container reservoirs and vesical substitutions, evaluating their contraindications within the neoplastic scope and/or psychosocial range, as well as comparing the reflux, stenosis and infection rates with our series, make the ureteroileal by-pass a technique entirely legitimate at present.