A novel technique of ureteroneocystostomy (extravesical seromuscular tunnel): A preliminary clinical study

Objectives. To present our initial clinical experience with the new techniq ue of extravesical seromuscular tunnel ureteroneocystostomy. Methods, The technique was performed in 21 patients for different indicatio ns; the most common was unilateral bilharzial stricture of the lower end of the ureter, The patients were regularly seen every 3 months during the fir st year, every 6 months during the second year, and annually thereafter dur ing a follow-up period of 24.2 +/- 10.2 months. A chemical profile, urine c ulture, and renal ultrasound scan were performed at every visit. A techneti um-99m diethylenetriaminepentaacetic acid renal scan was carried out at lea st once every 12 months. Ascending cystography and intravenous urography we re done at least once during the entire follow-up period. Results. The postoperative course was uneventful in all patients. Improveme nt in renal function was achieved in 16 patients and the remaining 5 experi enced stabilization. Improvement of the configuration of the corresponding renoureteral unit was observed in all but 4 patients who had stabilization to almost that of the preoperative condition. None of the 21 patients demon strated vesicoureteral reflux during the follow-up period. Conclusions. The new technique of extravesical seromuscular tunnel is suita ble for reimplantation of the dilated ureters, Other studies with a larger number of patients and a longer duration of follow-up are necessary to conf irm these results. UROLOGY 57: 1055-1058, 2001, (C) 2001, Elsevier Science Inc.