Cutaneous tube ureterostomy: a fast and effective method of urinary diversion in emergency situations
Authors Abdin T, Zamir G, Pikarsky A, Katz R, Landau EH, Gofrit O
Received 21 February 2015
Accepted for publication 10 April 2015
Published 11 June 2015 Volume 2015:7 Pages 101—105
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 5
Editor who approved publication: Dr Jan Colli
Tamer Abdin,1 Gideon Zamir,2 Alon Pikarsky,2 Ran Katz,1 Ezekiel H Landau,1 Ofer N Gofrit1
1Department of Urology, 2Department of General Surgery, Hadassah Hebrew University Hospital, Jerusalem, Israel
Aim: To report on a simple and rapid method of urinary diversion. This method was applied successfully in different clinical scenarios when primary reconstruction of the ureters was not possible.
Materials and methods: The disconnected ureter is catheterized by a feeding tube. The tube is secured with sutures and brought out to the lateral abdominal wall as cutaneous tube ureterostomy (CTU).
Results: This method was applied in three different clinical scenarios: a 40-year-old man who sustained multiple high-velocity gunshots to the pelvis with combined rectal and bladder trigone injuries and massive bleeding from a comminuted pubic fracture. Damage control included colostomy and bilateral CTUs. A 26-year-old woman had transection of the right lower ureter during abdominal hysterectomy. Diagnosis was delayed for 3 weeks when the patient developed sepsis. The right kidney was diverted with a CTU. A 37-year-old male suffered from bladder perforation and hemorrhagic shock. Emergency cystectomy was done and urinary diversion was accomplished with bilateral CTUs. In all cases, effective drainage of the urinary system was achieved with normalization of kidney function.
Conclusion: When local or systemic conditions preclude definitive repair and damage control surgery is needed, CTU provides fast and effective urinary diversion.
Keywords: Ureter, trauma, tube cutenuous ureterostomy
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