Ureterocutaneostomy: for whom and when?

Objective: To report and discuss the indications and the results of patients treated with ureterocutaneostomy (UCN) for urinary diversion in our center.

Material and methods: Between March 2008 and November 2012, 27 patients (19 males and 8 females) were treated with UCN. Patient age ranged from 56-78 years. Radical cystectomy was performed on 21 of these patients. The patients underwent transureteroureterostomy and UCN or unilateral or bilateral side-by-side UCN on the abdominal wall. Double-J stents were placed inside the ureters and changed every 12 weeks. Comorbidities and American Society of Anesthesiologists (ASA) scores were noted.

Results: Twenty-four patients presented with invasive bladder cancer, 1 patient with multiple tumors in and out of a diverticulum and recurrent hemorrhage, 1 patient with recurrent hemorrhage and 1 patient with bladder contracture. As comorbidities, 14 patients had hypertension, 11 patients had chronic obstructive pulmonary disease, 10 patients had diabetes mellitus, 8 patients had coronary artery disease, and 2 patients had chronic renal failure. One patient had Crohn’s disease. The ASA score was 3 or greater in 14 patients. At follow-up, 3 patients experienced pyelonephritis, and 1 had a strictured ureteral orifice.

Conclusion: UCN can be used as the method of urinary diversion in selected patients.