Ureterosigmoidostomy

A ureterosigmoidostomy is a surgically created connection ( anastomosis ) between the ureters and the sigmoid colon , the section of the large intestine in front of the rectum, for the purpose of draining urine . It is used - in addition to other procedures - when the natural discharge via the bladder and urethra is not or no longer possible.

indication

The most common indication is the removal of the urinary bladder ( cystectomy ) and the urethra because of a malignant tumor such as bladder cancer or prostate cancer . Inflammatory diseases such as fistulas between the intestine and bladder (enterovesical fistulas) or between the intestine and the genital organs (enterovaginal or enterogenital fistulas) can make urinary diversion necessary as part of their treatment, bypassing the bladder and urethra. There are basically three groups that differ based on their function:

• Continent urinary diversions with bladder replacement or catheterizable stoma .
• Incontinent urinary diversion with external stoma.
• The direct urine drainage into the large intestine, primarily into the sigmoid colon.

The latter, i.e. the ureterosigmoidostomy, is rarely used today because of the considerable risks and problems: The main disadvantages here are the change in the stool quality due to mixing with urine and the higher risk of infections of the upper urogenital tract ( pyelonephritis , glomerulonephritis ) due to intestinal germs. In addition, an increased incidence of colon cancer in the area of ​​the anastomoses has been described. In particular because of these complications, which are relatively common compared to other procedures, nowadays other procedures are usually given preference. Initially, the procedure was replaced by the MAINZ pouch technique.

See also

• Renal fistula

literature

• O. Hakenberg, M. Wirth: Urinary diversion after radical cystectomy. Current concepts in patients with bladder cancer . In: Der Onkologe , Vol. 3, No. 3, June 1997, pp. 254–264, doi: 10.1007 / s007610050120 , Springer-Verlag Berlin / Heidelberg, ISSN  0947-8965 (print) ISSN  1433-0415 (online)

Individual evidence

1. ↑ C.-H. Ohlmann et al .: Surgical techniques of urinary diversions . In: Journal Onkologie , Edition 02–05, journalonko.de, accessed on April 19, 2009

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