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Retrograde ureteroscopy in patients with orthotopic ileal neobladder urinary diversion.

Publication ,  Journal Article
Nelson, CP; Wolf, JS; Montie, JE; Faerber, GJ
Published in: J Urol
July 2003

PURPOSE: We assess the feasibility, technique, complications and clinical outcomes of retrograde ureteroscopy in patients with orthotopic ileal neobladder. MATERIALS AND METHODS: We retrospectively reviewed our ureteroscopy experience to identify procedures performed in patients who had previously undergone cystectomy with orthotopic ileal neobladder urinary diversion. These procedures were reviewed and data collected regarding patient characteristics, indication for endoscopic evaluation, surgical technique, findings, complications and followup. RESULTS: Eight patients with neobladder diversion were taken for 9 sessions in the cystoscopy suite for attempted retrograde ureteroscopy on 13 renal units. The indication for ureteroscopy was an upper tract filling defect, positive cytology or calculi. The ureter and renal pelvis were successfully accessed and visualized in 10 of 13 renal units. The cause of failure in the 3 unsuccessful procedures was inability to access the ureteral orifice. Mean operative time +/- SD was 78 +/- 34 minutes. Urothelial abnormalities were identified in 4 patients, extrinsic compression in 2 and stones in 3. In 1 patient postoperative hematuria developed, which spontaneously resolved. Fluoroscopy was essential to identify the afferent limb of the reservoir, and a directional guide wire was helpful in engaging the ureteral orifice. CONCLUSIONS: Ureteroscopic evaluation and treatment of upper tract abnormalities are feasible and practical in most patients with orthotopic neobladder urinary diversion. Identification of the ureteral orifice is challenging but can be accomplished with a combination of endoscopic and fluoroscopic techniques. This procedure avoids the morbidity of percutaneous access, and complications are minimal.

Duke Scholars

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

July 2003

Volume

170

Issue

1

Start / End Page

107 / 110

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Diversion
  • Ureteroscopy
  • Surgery, Computer-Assisted
  • Retrospective Studies
  • Postoperative Period
  • Middle Aged
  • Male
  • Ileum
  • Humans
 

Citation

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Nelson, C. P., Wolf, J. S., Montie, J. E., & Faerber, G. J. (2003). Retrograde ureteroscopy in patients with orthotopic ileal neobladder urinary diversion. J Urol, 170(1), 107–110. https://doi.org/10.1097/01.ju.0000070962.91546.bd
Nelson, Caleb P., J Stuart Wolf, James E. Montie, and Gary J. Faerber. “Retrograde ureteroscopy in patients with orthotopic ileal neobladder urinary diversion.J Urol 170, no. 1 (July 2003): 107–10. https://doi.org/10.1097/01.ju.0000070962.91546.bd.
Nelson CP, Wolf JS, Montie JE, Faerber GJ. Retrograde ureteroscopy in patients with orthotopic ileal neobladder urinary diversion. J Urol. 2003 Jul;170(1):107–10.
Nelson, Caleb P., et al. “Retrograde ureteroscopy in patients with orthotopic ileal neobladder urinary diversion.J Urol, vol. 170, no. 1, July 2003, pp. 107–10. Pubmed, doi:10.1097/01.ju.0000070962.91546.bd.
Nelson CP, Wolf JS, Montie JE, Faerber GJ. Retrograde ureteroscopy in patients with orthotopic ileal neobladder urinary diversion. J Urol. 2003 Jul;170(1):107–110.
Journal cover image

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

July 2003

Volume

170

Issue

1

Start / End Page

107 / 110

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Diversion
  • Ureteroscopy
  • Surgery, Computer-Assisted
  • Retrospective Studies
  • Postoperative Period
  • Middle Aged
  • Male
  • Ileum
  • Humans