Intestinal seromuscular tunneling: a novel method for ureteral replacement—an experimental design

Background Long-segment ureteral injuries may have different etiologies. Although multiple procedures have been previously used for ureteral replacement, none of them had optimum results, and replacement of long segments of injured ureter is still a challenging surgical problem. In this article, we...

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Bibliographic Details
Published in:International urology and nephrology 2015-08, Vol.47 (8), p.1351-1355
Main Authors: Hodjati, Hossein, Paidar, Jalal Khalili, Kumar, Perikala Vijayananda, Johari, Hamed Ghoddusi
Format: Article
Language:English
Subjects:
Animals
Dogs
Ileum - transplantation
Intestinal Mucosa - transplantation
Medicine
Medicine & Public Health
Nephrology
Prospective Studies
Ureter - injuries
Ureter - surgery
Ureteral Diseases - surgery
Urologic Surgical Procedures - methods
Urology
Urology - Original Paper
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Summary:Background Long-segment ureteral injuries may have different etiologies. Although multiple procedures have been previously used for ureteral replacement, none of them had optimum results, and replacement of long segments of injured ureter is still a challenging surgical problem. In this article, we have hypothesized that it may be possible to use intestinal seromuscular tunneling as a novel method for ureteral replacement. Methods This experimental study was conducted on eight dogs. After cutting the ureter at about its mid-part and ligating the distal part, a 10-cm tunnel was made in the seromuscular layer of small intestine using a metallic probe, and a catheter was passed through it. Proximal and distal ends of the tunnel were anastomosed to proximal end of ureter and urinary bladder, respectively. After 8 weeks, the dogs were killed, and their whole urinary system was sent for histopathologic examinations. Results No complication was noted during the post-op period. Histopathologic examinations confirmed that the seromuscular tunnel was well patent, lined by pseudostratified transitional epithelium and without any inflammatory reaction. Conclusion Our study shows that ureteral replacement by intestinal seromuscular tunneling is anatomically possible at least in animal model. However, more well-designed prospective studies are needed to confirm its long-term functional results.
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-015-1027-8