Ileal conduit as a form supravesical derivaton, is still one of most popular
method of urinary diversion, in daily urological practice. Bearing in mind
this fact, this type of diversion, rightfully so, is also called the "gold
standard" in the derivation of urine. Considering the fact of unnatural route
of elimination of urine from the upper urinary tract that occurs during
creation of ileal conduit, it is reasonable to expect that, in time, this
type of diversion lead to some degree of renal insufficiency. Some authors,
this effect on renal function, attribute to specific type of
ureterointestinal anastomosis during formation of ileal conduit1,2. A very
important part of the surgical technique of creating ileal conduit is
precisely a step of implantation ureters into the intestinal segment. The
ultimate goal is to enable a more natural way of evacuation of urine from the
upper urinary tract in terms of maintaining the quality of renal function.
Numerous authors describes a quite number of techniques of ureteral
implantation into the intestinal segment (Wallace A, Wallace B,
Nesbit-Bricker, Le Duc ...)3,4. Each of these techniques has its own
strengths and weaknesses, and the decision witch technique will be applied is
still in the hand of urologist - operator, individually. Bearing in mind the
fact of unnatural route of elimination of urine from the upper urinary tract
that occurs during creation of ileal conduit, it is reasonable to expect that
the renal function over the time will start to show signs of incipient or
advanced failure 5,6,7,8. Objective: To determine the most appropriate type
ureterointestinal anastomosis in forming ileal conduit, as a form of
supravesical urinary diversion, to ensure adequate renal function
postoperatively as an important parameter of quality of life. Methods and
patients: This is a retrospective study, which covered a population of 193
patients treated at the Department of Urology, Clinical Center of Serbia, who
underwent creation of ileal conduit as a form of urinary diversion. The study
was conducted 2007. - 2011. Postoperative follow-up lasts up to 48 months.
The assess of the level of renal insufficiency were analyzed by monitoring
parameters which determine the degree of anemia, and biochemical parameters
of renal function. We have investigated three techniques of insertion of the
ureters into the ileal conduit, which are used in the daily practice (Wallace
A, Wallace B, Nesbit-Bricker). Conclusion: Kidney failure occurs equally
often in all patients who underwent urinary diversion by ileal conduit,
ignoring the type of insertion of the ureters to the intestinal segment.
Procena stepena bubrezne insuficijencije kod pacijenata podvrgnutih ilealnom konduitu kao vidu derivacije urina u odnosu na vrstu insercije uretera
