Urinary Diversion: Anastomosis of the Ureters into a Sigmoid Pouch and End-to-Side Sigmoidorectostomy

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Abstract
From 1978-1982, bilateral ureterorectostomy and end-to-side sigmoidorectostomy were done following cystectomy for carcinoma of the bladder in 7 patients. No patient had recurrent pyelonephritis or ureterointestinal obstruction. Rectography showed the absence of rectoureteral reflux of contrast medium but rectosigmoid reflux appeared after injection of 150 ml opaque solution. Adequate alkali therapy was performed in 2 patients with hyperchloremic acidosis. While there were some problems concerning the quality of urinary and fecal control achieved in these patients they were no worse than those of ordinary ureterosigmoidostomy. This operation may be recommended for patients in whom a collection appliance is unacceptable. Before this surgical procedure can be performed the fact that the end result in terms of fecal urinary continence is unpredictable must be explained thoroughly to the patient.