Article révisé par les pairs
| Résumé : | We give a general view of the various operative methods of ureteral substitution. We discuss different ureter segments as well as total ureteral substitution separately. There are various solutions and one might conclude that parallel to a decrease in ureteral pathology, there has been a considerable increase in the choice between the many procedures to replace the ureter partly or totally. The ureter can be replaced by the renal pelvis, the bladder, the opposite ureter and by intestinal grafts. Replacement of the middle third is satisfactorily attained by renal descent, by transplanting the right renal vein or the left renal artery. The general tendency is to avoid intestinal grafts in favour of vascular surgery and autotransplantation. However, total substitution by an ileal graft is still indicated in rare cases where a severe retroperitoneal fibrosis is a contraindication to vascular surgery. |
