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March 1965

Ileo-Ureteral Nipple: A Modified Cutaneous Ureterostomy

Author Affiliations

From the Urology Section of Roswell Park Memorial Institute. Associate Research Cancer Urologist (Dr. Martin), and Chief Research Cancer Urologist (Dr. Woodruff).

Arch Surg. 1965;90(3):332-336. doi:10.1001/archsurg.1965.01320090010003

THE classical procedure of cutaneous ureterostomy has proved to be an unsatisfactory operation. Most of the patients who undergo it require a permanent indwelling ureteral catheter for adequate drainage of the kidney pelvis. Stricture at the skin ostium, calculus formation, persistent kidney infection, and renal deterioration are constant threats.

Many attempts have been made to solve these problems and to improve the efficiency of this procedure. The prevention of stricture at the ostium has been attempted through elaborate skin-to-ureter anastomosis technique. Nipples have been formed around the ureteral ostium by means of skin pedicle flaps or split thickness skin grafts. In a review of 174 cases of cutaneous ureterostomy, Humphreys1 concluded that the unfavorable end result was not benefited by any present type of stomal revision.

Our research on bilateral cutaneous ileoureterostomy,2 a new procedure of supravesical diversion, was initiated in 1963 and is still in progress. This

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