Objectives. Traumatic loss of significant lengths of ureter all too of
ten results in nephrectomy when vascu larized pedicles of bower or bla
dder fail or are not available for substitution. Historically, allopla
stic replacement of ureters has failed due to obstruction, bioincompat
ibility, or graft migration. This study was undertaken to test the per
formance of ringed expanded polytetrafluoroethylene (PTFE) tube grafts
as ureteral replacements in a canine model. Methods, Eight female dog
s underwent partial ureteral replacement with ringed PTFE tube grafts.
An involuting anastomosis was used to anchor the graft to the bladder
. The dogs were followed with intravenous urograms and Whitaker infusi
on pressure tests for up to 12 months. Results, Six of 8 animals (75%)
had preservation of excellent renal function with normal intravenous
urograms and low Whitaker infusion pressures. One animal had mild hydr
onephrosis with an elevated infusion pressure. One animal died of spon
taneous renal rupture secondary to obstruction at the ureteral-graft a
nastomosis. All other grafts were patent by histologic examination wit
hout encrustation or infection. Conclusions. Although not suggested as
first-line therapy after ureteral loss, expanded PTFE may have a use
as a prosthetic ureteral replacement in situations where conventional
surgical therapies are unsuccessful. This material appears to be bioco
mpatible, and the technique of bladder anastomosis described here prev
ented migration of the prosthesis.