Further experience with split-cuff nipple ureteral reimplantation in urinary diversion

Purpose: The intermediate followup results with split-cuff nipple ureteral reimplantation in larger numbers of urinary diversion patients are reviewed. Materials and Methods: Split-cuff nipple ureteroenteric anastomosis was performed in 98 ureters of 51 adult patients. Mean duration of followup was 23 months (range 3 to 62). Two minor variations in technique compared to the original report are presented. Results: Urinary reflux was prevented in 97.6 and 96.8% of cases at 1 and 2-year followup, respectively. Ureteroenteric anastomotic obstruction occurred in 3.1% of ureters by 3 months postoperatively. No cases of anastomotic leak or later obstruction occurred. Four episodes of acute pyelonephritis occurred in the early postoperative period. Conclusions: The split-cuff nipple ureteral reimplant technique in urinary diversion continues to provide excellent results with low rates of reflux or obstruction. The 2 described minor technical modifications further simplify the procedure.