Application Of Ureterocutaneostomy As Urinary Diversion After Radical Cystectomy In The Treatment Of Bladder Cancer.

Since Simon performed uretero-colic anastomosis on a patient with exstrophy of bladder in 1852,the means for urinary diversion after radical cystectomy were investigated and discussed by surgeons of uronology.Various kinds of controllable cystoplasty and urinary diversion were continuously invented after early 1980's since when Kock reported his successful experience on controllable ileal conduit. Johnston(1963)described bilateral side-to-side cutaneous ureterostomy as a procedure for urinary diversion.It was originally described as a means of diversion in children with congenital urinary obstruction but later used in adults with pelvic malig-nancies for palliative diversion.Ureterostomies are now relatively rare performed in the adult population for permanent urinary diversion but are still an attractive means performed in patients of later stage bladder cancer.This research retrospectively analyzed the data of 51 cases with bladder cancer during May 2005 and July 2007 who underwent radical cystectomy plus ureterocutaneostomy,comprehend thier complication and satisfaction degree of life. Consulted lots of literatures,and compared with bowel cystoplasty to discuss the value and effects of ureterocutaneostomy as urinary diversion after radical cystectomy to patients of bladder cancer.The main objects of study:(1).Record complete clinical data of patients which underwent ureterocutaneostomy and radical cystectomy.(2).Obtain follow-up data of selected patients.(3).Cosulted literatures to learn the fellow-up of patients after radical cystectomy with other means of urinary diversion.(4).Analys the value and effects of ureterocutaneostomy as urinary diversion after radical cystectomy to patients of bladder cancer.Materials and methods:Retrospectively analyzed the data of 51 cases with bladder cancer during May 2005 and July 2007 who underwent radical cystectomy and ureterocutaneostomy,Result 5 cases occured stenosis of ureter and needed to detain ureteral catheter for a long term,3 cases occurred regular urinary tract infection,2 cases occured malunited of stoma and performed stomaplasty,2 cases occurred gross hematuria and improved with symptomatic treatment,1 case occurred urethra stump cancer 12 monthes postoperative and performed a radical urethrectomy,.There were no patient found electrolyte disturbance or damage of renal function or nephropyelitis,most of the patients satisfied with their postoperative life quality.Conclution Compared with orthotopic ileal neobladder in the treatment of bladder cancer,ureterocutaneostomy is simpler and could avoid problems caused by the newly plastied baldder such as urine retention,electrolyte disturbance ect.,it is a valuable choise for patient with bladder cancer,and it worth to be more wildly used.