EVALUATION OF URETEROCYSTOPLASTY AS AN ALTERNATIVE FOR AUGMENTATION ILIOCYSTOPLASTY IN THE PRESENCE OF DILATED URETERS

Document Type : Original Article

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Department Urology, Faculty of Medicine, Ain Shams University.

Abstract

Background: Ureterocystoplasty has been considered as an alternative for iliocystoplasty when there is dilated ureters in
association with renal impairment/extensive ileal resection, several studies reported variable results after ureterocystoplasty Aim of the work: To compare the outcomes of augmentation ureterocystoplasty in patients with dilated ureters to conventional augmentation iliocystoplasty in patients who can undergo both procedures. Patients and Methods: In a prospective randomized clinical study, 10 patients will undergo ureterocystoplasty; another 10 patients will undergo iliocystoplasty. The inclusion criteria include patients with unilateral or bilateral ureteric dilatation after failure of conservative measures. The Exclusion criteria were insufficient ureteric dilatation, elevated S.creat. or previous extensive ileal resection Results: Our results showed significant improvement in capacity and compliance in all groups, the degree of urodynamic improvement was however inferior when the distal segment of 2 ureters were used for augmentation versus the use of ileum or an entire ureter of a nonfunctioning kidney, the degree of hydronephrosis improved or resolved in all patients, continence improved in all patients despite the requirement for CIC in most patients, the frequency of urinary tract infections was similar in both groups. Conclusions: Our study concludes that augmentation with sufficient amount of ureteric tissue provides adequate augmentation with similar urodynamic outcome to augmentation with the use of
ileum, however if the ureteric tissue used was insufficient such as when using the distal segment of 1 or 2 ureters especially when the ureters are not sufficiently dilated the improvement in urodynamic outcome was inferior to the use of ileum.

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