URETERAL REPLACEMENT WITH RECONFIGURED COLON SUBSTITUTE

Purpose: Upper ureteral defects are often too extensive to repair by d irect anastomosis or with use of a bladder flap. Ureteral substitution may be the only remaining alternative to restoring urinary drainage f rom the kidney to the bladder. This effect is usually achieved by inte rposing a segment of small bowel between the proximal collecting syste m and bladder. If ileum is not available other substitution alternativ es must be sought. Materials and Methods: We report a new technique in which a tube constructed from a small piece of ascending colon was us ed to replace a large ureteral defect. Results: Excellent short-term r esults were achieved by replacing the strictured ureteral segment with a reconfigured colon segment as shown by symptomatic and radiographic improvement. Conclusions: A reconfigured colon segment can be used fo r ureteral reconstruction in the patient with limited alternatives. Th is tube has several advantages for ureteral reconstruction over ileal segments.