Abstract After implantation of the ureters into the colon, serious sequelae, such as hydronephrosis and pyelonephrosis, are possible. The pathologic physiology of the ureters is significant. At least six factors are interrelated. PERITONITIS After direct implantation the incidence of peritonitis is high. In animals this condition occurs rarely after submucous implantation. Coffey's1 method of constructing a ureterointestinal valve aided in preventing peritonitis. Hyperperistalsis in the colon, especially after bilateral implantation, contributes to the tendency toward leakage, particularly if specialized instruments are used in the ureters or in the rectum. INFECTION OF THE URETER AND KIDNEY Bacterial invasion of the ureter occurs through the hiatus in the ureteral mucosa. David and Mattill2 have shown that it is improbable that infection of the renal pelvis occurs through involvement of the periureteral lymphatics. Rather, extension of infection is via the lumen of the ureter. Vermooten3 has shown that ureteral elasticity is References 1. Coffey, R. C.: Physiologic Implantation of the Severed Ureter or Common Bile-Duct into the Intestine , J. A. M. A. 56:397 ( (Feb. 11) ) 1911.Crossref 2. David, V. C., and Mattill, P. M.: Role of the Ureteral Lymphatics in Experimental Urinary Tract Infections , Arch. Surg. 2:153 ( (Jan.) ) 1921.Crossref 3. Vermooten, V.: Transplantation of the Lower End of the Dog's Ureter: An Experimental Study , J. Urol. 32:273, 1934. 4. Hinman, F.: Ureterointestinal Anastomosis , Surgery 2:127, 1937. 5. Mayo, C. H.: The Formation of a Cloaca in the Treatment of Exstrophy of the Bladder , S. Clin. North America 1:125, 1920. 6. (a) Walters, W.: Transplantation of Ureters to Sigmoid Colon for Exstrophy of Bladder and Other Ureteral Abnormalities with Urinary Incontinence , Minnesota Med. 16:416, 1933. 7. (b) Walters, W., and Braasch, W. F.: Ureteral Transplantation to Rectosigmoid for Exstrophy of the Bladder, Complete Epispadias, and Other Urethral Abnormalities with Total Urinary Incontinence: A Study of Eighty-Five Operative Cases , Am. J. Surg. 23:255, 1934Crossref 8. Transplantation of Solitary Ureter to the Sigmoid Colon for Exstrophy of the Bladder: Report of a Case , Proc. Staff Meet., Mayo Clin. 9:485, 1934 9. Ureterosigmoidal Transplantation for Exstrophy of the Bladder and Complete Epispadias with Absent Urinary Sphincters , Am. J. Surg. 24:776, 1934Crossref 10. Plastic Operations on the Genito-Urinary Tract: I. Operations on the Ureters and Kidney , Proc. Staff Meet., Mayo Clin. 10:529, 1935 11. Implantations of Ureters into the Colon , Surgery 2:12, 1937. 12. Coffey, R. C.: Production of Aseptic Uretero-Enterostomy by a Suture Transfixing the Ureteral Wall and the Intestinal Mucosa , J. A. M. A. 94:1748 ( (May 31) ) 1930.Crossref 13. Higgins, C. C.: Aseptic Ureterointestinal Anastomosis , J. Urol. 31:791, 1934. 14. Bergenhem, B.: Ectopia Vesicae: Adenoma Destruans Vesicae; Exstirpation of the Bladder; Implantation of End of the Ureter into the Rectum , Eira 19:268, 1895. 15. Maydl, K.: Neue Beobachtungen von Ureterenimplantation in die Flexura romana bei Ectopia vesicae , Wien. med. Wchnschr. 46:1241-1247, 1896. 16. Martin, F. H.: Implantation of Ureters in Rectum: A Method Having for Its Object the Making of Subsequent Infection of the Ureters and Kidneys Impossible , J. A. M. A. 32:159 ( (Jan. 28) ) 1899.Crossref 17. Peters, G. A.: Transplantation of Ureter into Rectum by an Extra Peritoneal Method for Exstrophy of Bladder , Brit. M. J. 1:1538, 1901.Crossref 18. Fowler, G.: A Treatise on Surgery , Philadelphia, W. B. Saunders & Company, 1906, vol. 2, p. 313. 19. Coffey, R. C.: Transplantation of the Ureters into the Large Intestine , Surg., Gynec. & Obst. 47:593, 1928. 20. Kirwin, T. J.: A Study of Ureteral Implantation with a Description of a New Procedure: A Preliminary Report , Am. J. Surg. 8:1, 1930. 21. Ferguson, C.: Experimental Transplantation of the Ureters in the Bowel by a Two Stage Operation , Mil. Surgeon 69:181, 1931. 22. Beaver, M. G., and Mann, F. C.: Brief Communications: Simple Method for the Transplantation of the Ureter and the Common Duct into the Intestine , Ann. Surg. 95:621, 1932. 23. Winsbury, H. P.: A New Method of Implanting the Ureters into the Bowel , Proc. Roy. Soc. Med. 26:1214, 1935. 24. Hinman, F.: A Simple Seven Suture Method of Bilateral Uretero-Intestinal Implantation , Surg., Gynec. & Obst. 61:802, 1935. 25. Brenizer, A. G.: Ureteral Transplantation: Modification of Methods , Am. J. Surg. 28:210, 1935. 26. Sherman, W. L.; Dinardo, C. J., and Bowers, J. M.: Ureteral Transplant: Preliminary Report of a New Technique , Am. J. Surg. 29:54, 1935. 27. Poth, E. J.: Aseptic Uretero-Enterostomy , Surg., Gynec. & Obst. 60:875, 1935. 28. Douglass, H. L., and Edwards, L. W.: Experimental Studies of Uretero-Intestinal Anastomosis , Ann. Surg. 104:87, 1936. 29. Hinman, F.: Uretero-Intestinal Implantation by Aseptic Method with Divisible Carrier: Modification of Simple 7 Suture Method with Probe and Cautery , Tr. Am. A. Genito-Urin. Surgeons 29:157, 1936. 30. Altounyan, E. H. R.: Modified Coffey Operation for Transplanting Ureters , Lancet 2:191, 1937. 31. Foley, F. E. D.: Aseptic Ureterosigmoidostomy: A New Method Providing Definite Asepsis in Respect to Both Fecal and Urinous Soiling; a Preliminary Report , Surgery 2:18, 1937. 32. Douglass, H. L., and Edwards, L. W.: Ureteral Enterostomy Combination of Coffey, Ferguson, and Brenizer Methods , J. Tennessee M. A. 30:41, 1937. 33. Farrell, J. I., and Lyman, Y.: Aseptic Uretero-Intestinal Anastomosis , Surg., Gynec. & Obst. 66:657, 1938. 34. Jordan, E. P.: Aseptic Uretero-Intestinal Anastomosis: An Experimental Study , J. Missouri M. A. 35:365, 1938. 35. Cabot, H.: The Methods of Diverting Urine Above the Level of the Bladder, with Particular References to Problem of Technic , J. Urol. 35:596, 1936.
Archives of Surgery – American Medical Association
Published: Apr 1, 1940
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