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Le Duc-Camey procedure as a method of ureteroileal implantation on augmentation cystoplasty in patients with myelodysplasia]
Authors:A Hirayama  T Ono  Y Kawata  N Hirata  M Yamamoto  H Momose  K Yamada  T Shiomi
Institution:Department of Urology, Hoshigaoka Koseinenkin Hospital.
Abstract:PURPOSE: We investigated the results of Le Duc-Camey procedure as a method of ureteroileal implantation on augmentation cystoplasty in patients with myelodysplasia. MATERIALS AND METHODS: A total of 14 patients (25 renal units) underwent ureteroileal implantation with Le Duc-Camey procedure on augmentation cystoplasty. The possible causes of complications concerning ureteroileal implantation that developed during the postoperative observation were classified as preoperative factors and postoperative factors.: The preoperative factors were the causative disease required ureteroneostomy, the grade of preoperative VUR, and the ureteral diameter at the anastomosis with the ileum.: The postoperative factors were the volume, and the compliance of the urinary bladder, and the maximum intravesical pressureled by the peristalsis of the utilized intestine. RESULTS: With the mean observation period of 31.6 months, no complications developed but VUR observed in 4 renal units of 4 patients. The patients with VUR had a larger ureteral diameter at the anastomosis site to the ileum among the preoperative factors and a significantly larger maximum intravesical pressure led by the intestinal peristalsis among the postoperative factors when compared with the patients without VUR. CONCLUSION: Regarding ureteroileal implantation with Le Duc-Camey procedure on augmentation cystoplasty in patients with myelodysplasia. It seems necessary to consider some countermeasures for the dilated ureters and for the unexpected 2 elevation of intravesical pressure due to the peristalsis of the utilized intestine.
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