Early results with split-cuff nipple ureteral reimplants in urinary diversion.

Abstract

A split-cuff nipple technique was developed for ureteral reimplantation in urinary diversion. Ureteroenteric anastomosis was performed with a uniform split-cuff nipple technique in 46 ureters of 24 adult patients undergoing various forms of conduit or continent urinary diversion. The outcome of 42 reimplants in 22 patients (mean followup 22.5 months, minimum 10) was analyzed. The technique is described in detail. Reflux was prevented in 97.6% and 95% of cases at initial and 2-year followup, respectively. Neither anastomotic leakage nor obstruction occurred. There were 2 episodes of pyelonephritis in the early postoperative period. Results are compared with those in the literature of ureteroenteric anastomoses in general and of various split-cuff nipple techniques. The technique is easy to perform. Favorable early results warrant continued use of the procedure. Long-term followup in a larger number of patients is indicated.