PTU - Polskie Towarzystwo Urologiczne
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Subcutaneus urinary diversion ? alternative to percutaneus nephrostomy
Article published in Urologia Polska 2005/58/3.


Leszek Szymański 1, Marek Salagierski 1, Marek Lipiński 1, Małgorzata Gołąb-Lipińska 2, Leszek Jeromin 1
1 Klinika Urologii z Pracownią Litotrypsji Uniwersytetu Medycznego w Łodzi
Kierownik kliniki: prof. dr hab. Leszek Jeromin
2 Klinika Perinatologii I Katedry Ginekologii i Położnictwa Uniwersytetu Medycznego w Łodzi
Kierownik kliniki: prof. dr hab. Tadeusz Laudański


kidney, hydronephrosis, subcutaneus urinary diversion


Introduction and objectives.
Percutaneus nephrostomy has been the standard method of urinary diversion when placement of ureteral stents has failed in cancer patients. The aim of the study is to esteem the value of subcutaneous urinary diversion as an alternative to percutaneus nephrostomy.
Material and method.
We describe an alternative method of urinary diversion, proposed by Paterson and Forrester in 1994, subcutaneous nephrostomy. In 2004 this procedure was performed in 32 years old women with leyomiosarcoma of minor pelvis with dilatation of renal pyelo-calyceal system. Many attempts of placement of ureteral stent were failed. The diversion was created by specially designed 7F double pigtail stent. The proximal end of the stent was inserted into renal pelvis via a percutaneus nephrostomy puncture. A subcutaneous tunnel were created from the flank to the bladder down through which the distal end of the stent was passed and via a suprapubic bladder puncture the stent were passed into the bladder.
After 4 months no dilatation of renal pyelo-calyceal system was observed. No pains or dysuria were observed during 8 months of follow-up.
Our early experience with this extra-anatomical method of urinary diversion suggests it to be a safe, effective and acceptable alternative to nephrostomy that improves quality of life.


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Leszek C. Szymański
Klinika Urologii z Pracownią Litotrypsji UM
ul. Pabianicka 62
93-513 Łódź
tel. (042) 68 95 211