Reflux, Stricture and Glomerular Filtration Rate after Two Antireflux Techniques in Continent Urinary Reconstruction Using the Right Colon

Abstract

In the present study the incidence of reflux, stricture formation and changes in glomerular filtration rate in patients with the submucosal tunnel or the Carney-Le Duc technique of ureteric implantation into the caecum/detubularized right colon used for continent cutaneous diversion/orthotopic bladder substitution was investigated. Reflux was found in two renal units and ureterointestinal stenosis occurred in five renal units after submucosal tunnel ureteric implantation. After Carney-Le Duc ureteric implantation, one renal unit showed reflux and none had stenosis of the ureterointestinal anastomosis during follow-up. Mean glomerular filtration rate (ml/min/1.73 m²) fell from 98 to 85 in the submucosal tunnel group and from 88 to 81 in the Carney-Le Duc group after mean follow-ups of 9 and 5 years, respectively. Both methods of ureteric implantation in this study were effective in preventing reflux, and renal function was well preserved in both groups. The absence of ureterointestinal strictures in the Carney-Le Duc group is encouraging and indicates that this is a reliable method for reflux prevention.

Key Words:

• antirefluxing ureteric anastomosis
• continent urinary reconstruction
• glomerular filtration rate
• reflux
• stenosis