Use of Intestinal Segments in Urinary Diversion: Experience With Eight Cases at The Jos University Teaching Hospital, Jos

Abstract

Background: Reconstructive urologic surgery frequently requires use of bowel for ureteral substitutes, bladder augmentation, or bladder replacement. In rare cases, gastrointestinal segments may also function as urethral or vaginal substitutes. This study gives an insight into the indications and uses of various intestinal segments in urinary diversion in our centre. Patients and methods: A nine year review of patients who had urinary diversion using intestinal segment from 2005 to 2014 was done. All patients underwent preoperative evaluation in the form of careful history taking, medical examination and laboratory investigations which included complete urine analysis, serum creatinine, sodium, potassium and chloride. Radiological investigations to visualize the urinary tract included ultrasonography, intravenous urography or CT urography and cystoscopy and biopsy. Patients’ age, sex, indication for urinary diversion, intestinal segment used, type of urinary diversion and complications related to use bowel segment were analyzed. Results: Total of eight patients had urinary diversion using intestinal segments. The mean age of the patients was 47.4years (range 14 ˗ 66years). Six of the patients were males (75%) while two were females (25%). Indications for use of intestinal segment in this study were complete ureteral stenosis from schistosomiasis, bladder exstrophy and carcinoma of the bladder. The types of urinary diversion were ileal ureteral replacement, rectosigmoid pouch and ileal neobladder. Conclusion: Intestinal segments have become a veritable tool in reconstructive urology and they may be used to reconstruct a functionally normal urinary tract in terms of transport, storage, voiding, continence and preservation of renal function.