Progressive ureteral dilation for subsequent ureterocystoplasty

Nicholas G. Lailas, Bartley Cilento, Anthony Atala

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Purpose: The complications associated with bladder augmentation using the gastrointestinal tract are well known. A bladder based ureteral flap is a viable alternative for augmentation. However, its use is limited to cases in which a dilated ureter is already present due to associated pathological conditions, such as reflux. We designed a system for performing progressive dilation in a normal ureter, which can subsequently be used for augmentation. Materials and Methods: Ten rabbits underwent unilateral ureteral ligation at the ureterovesical junction and ipsilateral nephrectomy. A silicone catheter was threaded into the proximal ipsilateral ureter and connected to an injection port, which was secured subcutaneously. Ten days to 2 weeks after surgery a saline-antibiotic solution was injected subcutaneously daily into the injection port. Cystography and cystometrography were performed with an accurate measurement of bladder capacity. Ureterography was done initially and then weekly by injecting contrast medium into the ureter. After ureteral dilation ureterocystoplasty was performed in each animal. Results: After 1 month of daily saline-antibiotic solution injections the ureteral units were dilated at least 10-fold, as measured by radiography. The dilated ureteral diameter exceeded that of adjacent colon in each instance. Augmentation cystoplasty was performed with the reconfigured dilated ureteral segment. Repeat cystography and cystometrography showed an average 260% increase in bladder capacity (range 190 to 380%). Conclusions: Ureteral dilation can be accomplished using our system. At least a 10-fold increase in ureteral size is possible. The dilated ureteral segment can be used effectively for bladder augmentation, avoiding the use of bowel segments.

Original languageEnglish
Pages (from-to)1151-1153
Number of pages3
JournalJournal of Urology
Volume156
Issue number3
StatePublished - Sep 1 1996
Externally publishedYes

Fingerprint

Dilatation
Ureter
Urinary Bladder
Sodium Chloride
Injections
Anti-Bacterial Agents
Silicones
Nephrectomy
Radiography
Contrast Media
Ligation
Gastrointestinal Tract
Colon
Catheters
Rabbits
Cystography

Keywords

  • bladder
  • rabbits
  • ureter

ASJC Scopus subject areas

  • Urology

Cite this

Lailas, N. G., Cilento, B., & Atala, A. (1996). Progressive ureteral dilation for subsequent ureterocystoplasty. Journal of Urology, 156(3), 1151-1153.

Progressive ureteral dilation for subsequent ureterocystoplasty. / Lailas, Nicholas G.; Cilento, Bartley; Atala, Anthony.

In: Journal of Urology, Vol. 156, No. 3, 01.09.1996, p. 1151-1153.

Research output: Contribution to journalArticle

Lailas, NG, Cilento, B & Atala, A 1996, 'Progressive ureteral dilation for subsequent ureterocystoplasty', Journal of Urology, vol. 156, no. 3, pp. 1151-1153.
Lailas NG, Cilento B, Atala A. Progressive ureteral dilation for subsequent ureterocystoplasty. Journal of Urology. 1996 Sep 1;156(3):1151-1153.
Lailas, Nicholas G. ; Cilento, Bartley ; Atala, Anthony. / Progressive ureteral dilation for subsequent ureterocystoplasty. In: Journal of Urology. 1996 ; Vol. 156, No. 3. pp. 1151-1153.
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