Modified technique for urinary diversion with incontinent conduits

BACKGROUND: Incontinent urinary diversions are frequently performed in gynecologic oncology. The incontinent urinary diversions generally utilize a short segment of distal ileum or colon as a conduit. Conduit complications such as anastomosis leaks and strictures may be related to the technique utilized for inserting and securing the ureters and the degree of postimplant manipulation. TECHNIQUE: We describe a technique using a metal Yankaur suction device placed through the conduit's matured stoma to facilitate the mucosa-to-mucosa anastomosis of the ureters. This procedure allows for tension-free ureteral anastomoses, the isolation of the ideal conduit length, optimal stomal maturation, and reduced manipulation of the conduit after the ureteral anastomoses. CONCLUSION: This modification provides an elegant, yet simple and expedient, method of ureteral anastomosis to the incontinent urinary conduit.