Subcutaneousureteral Ureteral Bypass for Complex Ureteral Stenosis
2 months ago
Subcutaneousureteral bypass, also called pyelovesical bypass, is a permanent device used for the treatment of complex ureteral stenosis when all other treatments fail or not indicated, especially in oncologic patients with a permanent neohrostiomy. The solution improves the quality of life and conserves renal function. It consistes of a tube of 29 Fr external PTFE and 17 FR internal diameter silicone component. The proximal end is placed percutaneously into the renal cavities. A subcutaneous tract is created with a tunneler reaching the hypogastrium and the bladder is opened for about 1 cm though a 3-4 cm incision over the pubic bone. The device then is passed through the tunneler until it reaches the bladder. The distal end is then anastomosed to the bladder wall.