Complications of the non-refluxing colon conduit. 1980

J E Dagen, and E J Sanford, and T J Rohner

The non-refluxing colon conduit has been offered as a superior alternative to the ileal conduit for long-term supravesical urinary diversion. The main advantage would seem to be that the upper tracts can be protected by the formation of a ureterocolic anastomosis without reflux, thereby preventing the deterioration associated with ileal conduits, which is presumably secondary to reflux and ascending infection. Although a colon operation is potentially more hazardous than a small bowel operation the short-term complication rates are not significantly different. We report 2 cases of stenosis of the ureterocolic anastomosis to emphasize that this serious complication continues to be a potential problem with any procedure of this type. With long-term followup its present incidence in 8 to 10 per cent of the patients may exceed the incidence of conduits with reflux. In our 2 cases severe stenosis of the ureter within the tunnel was encountered at reoperation. Techniques that may help prevent stenosis include preservation of periureteral adventitia, careful formation and closure of the submucosal tunnel, forming an anastomosis free of tension and tapering the ureters, when necessary, adequately but not excessively. Correction of this complication may require lysis of surrounding adhesions, a ureterocolic anastomosis with reflux, transureteroureterostomy, transureteropyelostomy, replacement of the ureter with small bowel or nephroureterectomy.

UI MeSH Term Description Entries
D008297 Male Males
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003251 Constriction, Pathologic The condition of an anatomical structure's being constricted beyond normal dimensions. Stenosis,Stricture,Constriction, Pathological,Pathologic Constriction,Constrictions, Pathologic,Pathologic Constrictions,Pathological Constriction,Stenoses,Strictures
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012809 Colon, Sigmoid A segment of the COLON between the RECTUM and the descending colon. Sigmoid,Sigmoid Colon
D012810 Sigmoid Diseases Pathological processes in the SIGMOID COLON region of the large intestine (INTESTINE, LARGE). Sigmoid Colon Diseases,Colon Disease, Sigmoid,Colon Diseases, Sigmoid,Disease, Sigmoid,Disease, Sigmoid Colon,Diseases, Sigmoid,Diseases, Sigmoid Colon,Sigmoid Colon Disease,Sigmoid Disease
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D014515 Ureteral Diseases Pathological processes involving the URETERS. Disease, Ureteral,Diseases, Ureteral,Ureteral Disease

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