Ureteroileostomy, an Efficacious Method of Urinary Diversion

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Abstract
THE multiplicity of surgical procedures proposed1 to divert the urinary stream after total cystectomy shows that there has been no satisfactory solution to the major problems of obstruction, infection and hyperchloremic acidosis.Nephrostomy and cutaneous ureterostomy are not usually efficacious because they require intubation, which almost always leads to progressive pyelonephritis.In 1911 Coffey2 advocated tunneling of the ureter through the sigmoid wall to prevent reflux of bowel contents. Stricture of the anastomosis tended to occur, leading to obstruction and ascending infection. A long-term follow-up study on 144 ureterosigmoidostomies of this type for exstrophy of the bladder3 at the Mayo . . .