URETEROSIGMOIDOSTOMIES, BASED ON A SERIES OF 35 CASES

35 patients underwent ureterosigmoidostomy between 1986 and 1996, corr esponding to 25 males (71%) and 10 females (29%) with a mean age of 48 years (range: 21 to 81 years). 25 (71%) of these patients had invasiv e bladder cancer, 4 (12%) had a vesicovaginal fistula, 3 (9%) had blad der exstrophy and 3 (9%) had urethral trauma. All patients had normal renal function. In 2 patients, the ureter was dilated and in 3 other p atients, one kidney was silent. The postoperative course are marked by death in 2 cases (6%) due to myocardial infarction, mechanical obstru ction in 2 cases (6%), anastomotic dehiscence in 2 cases (6%). The mea n follow-up was 4 years (range: 2 to 10 years). Eight patients (22%) d eveloped impaired renal function, isolated hyperchloraemic acidosis wa s observed in 10 cases (28%), hypokalaemia was observed in 2 cases (6% ), and episodes of acute pyelonephritis were reported in 4 cases (11%) . Radiological signs of upper urinary tract deterioration were observe d in 6 cases (17%). A tumour of the sigmoid colon was observed in one case after a follow-up of 10 years. 25 patients (72%) remain dry throu ghout the night, while 8 (22%) need to empty their rectum during the n ight. The poorly tolerated Coffey diversion was replaced in 6 patients (17%). The objective of this study is to analyse the results of urete rosigmoidostomy and to emphasize the advantages and disadvantages of t his urinary diversion technique.