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Clinical outcome of tubeless cutaneous ureterostomy by the Toyoda method
Author(s) -
TERAI AKITO,
YOSHIMURA KOJI,
UEDA NOBUFUMI,
UTSUNOMIYA NORIAKI,
KOHEI NAOKI,
ARAI YOICHI
Publication year - 2006
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2006.01435.x
Subject(s) - medicine , ureterostomy , stoma (medicine) , surgery , hydronephrosis , urinary diversion , ureter , stenosis , urology , urinary system , cystectomy , cancer , bladder cancer
Aim: Cutaneous ureterostomy is the least invasive method of urinary diversion, but it carries a risk of stomal stenosis. We retrospectively examined the long‐term outcome of tubeless cutaneous ureterostomy by the Toyoda method. Methods: Since 1983, the Toyoda cutaneous ureterostomy has been performed in 97 patients (169 renal units) with a minimum follow up of 3 months. The ureteral patency rate was reviewed according to whether the stomal type was single (one ureter, one stoma) or double‐barrel (two ureters, one stoma). Results: After a median follow up of 23 months (range 3 to 169), a tubeless condition was achieved in 102 (82%) of 124 renal units associated with double‐barrel stoma and in 35 (78%) of 45 renal units associated with single stoma. Although mild to moderate hydronephrosis was observed in 19% of patients, serum creatinine levels did not change after a minimum of 12 months after surgery (median 35). Conclusions: A high ureteral patency rate was achieved with cutaneous ureterostomy using the Toyoda method. This procedure, especially double‐barrel stomal creation, is a reasonable alternative to other forms of urinary diversion in patients at high risk.