Ureterosigmoidostomy: reevaluation of a "forgotten" continent urinary diversion.

Between 1978 and 1983 we performed 19 ureterosigmoidostomies (25% of all urinary diversions). We try to realise a reevaluation of this technique by means of clinical data, laboratory findings, U.S.- and X-ray examinations. The mean follow-up time is 7.5 years. All patients mention a comfortable life-style. By routine administration of sodium bicarbonate, no electrolyte disturbances occur. Only 5 kidneys (on a total of 32 renal units) show major deformities. Colon carcinoma is not reported. Since the introduction of the ileal conduit by Bricker in 1950 (1), together with the repeatedly published higher incidence of colon carcinoma (2), a certain revulsion for the traditional Coffey-technique arose. Yet there are some important advantages in this peculiar surgical method. We think that, after a rather premature condemnation, the time is ripe for a reevaluation and a reevaluation of the ureterosigmoidostomy.

Multiple ureteral diverticula: report of 2 cases and review of the literature.

Multiple ureteral diverticula, probably acquired, are rare; they are most frequently diagnosed in elderly males and associated with infections of the urinary tract and prostatic hypertrophy. There is no definite treatment. On the other hand, one should be well aware of the possibly higher risk of transitional cell carcinoma. At least yearly urinalysis and cytology seem mandatory.

An alternative route for sequential venous grafts of the lateral aspect of the heart.

An alternative route, using the oblique pericardial sinus, is described for single and sequential vein grafts of the lateral aspect of the heart. This technique prevents kinking of the graft, reduces the need for excess vein length, and is an elegant way of protecting the graft in case a resternotomy is necessary. When the route was used in 63 patients, no technique-related morbidity or mortality was encountered.