Non-modelled replacement uretero-ileoplasty.

Objectives: To evaluate the indications and results of replacement uretero- ileoplasties performed over the last six years. Material and Methods: Over a period of 6 years, 8 patients underwent subtot al or total replacement uretero-ileoplasty involving a total of 9 renal uni ts. Preoperative temporary urinary diversion was performed in each patient. The, mean preoperative serum creatinine was 88 mu mol/l (range: 53 to 150) . Uretero-ileoplasty was performed for ureteric stricture in 7 cases (bilat eral in one case and in a solitary kidney in one case), ureteric necrosis f ollowing renal transplantation without a donor ureter in one case and uroth elial tumour on a solitary kidney in one case. Results: The mean follow-up was 54 months. The mean operating time was 218 minutes for uretero-unilateral ileoplasties, with a mean length of hospital stay of 12 days (range: 10 to 18 days). The following complications were o bserved: acute urinary retention, stenosis of the ileo-vesical implantation treated by endoscopic dilatation, 2 incisional hernias after midline lapar otomy. one case of stones of the ileo-vesical anastomosis, non-febrile urin ary tract infections treated on an outpatient basis. The functional result was considered to be satisfactory in every case. No electrolyte disorders w ere observed. Mean postoperative serum creatinine was 86 mu mol/l (range: 5 9 to 140). Conclusion: In this recent series with a mean follow-up of 4.5 years, repla cement uretero-ileoplasty successfully treated partial or total complex ure teric lesions with a low morbidity.