Long-term Functional Outcomes After Ileal Ureter Substitution: A Single-center Experience

OBJECTIVES To assess the indications and outcomes of ileal ureter replacement for ureteral reconstruction, which remains a technique of choice in certain cases, notably when the ureter has been injured. METHODS A retrospective review of the data from patients treated with ureteroileoplasty from 1980 to 2010 was performed. The following data were analyzed: age, etiology of ureter injury, and pre- and postoperative creatinine levels. Follow-up visits occurred at 3 and 6 months postoperatively and at least annually thereafter. RESULTS A total of 17 patients with a median age of 43 years were included. The main etiology of the ureteral defect was an iatrogenic ureteral injury after a urologic procedure (n = 6). The mean length of hospital stay was 12.4 +/- 8 days (range 7-26). Four major complications (grade 3) and 5 minor complications (grade 2) developed. The median follow-up time was 174 months. The mean creatinine level before surgery, at 1 month after surgery, and at the last follow-up visit was 1.3 +/- 0.3 mg/dL (range 0.6-3.4), 1.4 +/- 0.4 mg/dL (range 0.6-3.6), and 1.8 +/- 0.6 mg/dL (range 0.7-4.7), respectively. By the end of the follow-up period, 15 patients still had ileal ureters. Of these, 3 required dialysis. CONCLUSIONS The indications for an ileal ureter have evolved in recent years. The ileal ureter appears to remain a reasonable option for ureteral reconstruction to preserve long-term renal function. UROLOGY 78: 692-695, 2011. (C) 2011 Elsevier Inc.