Bilateral Simultaneous Ureterosigmoidostomy for Chronic Interstitial Cystitis
Transplantation of the ureters into the rectosigmoid is now a recognized procedure in the treatment of various types of intractable lesions of the bladder. Its success has been proved in the treatment of exstrophy of the bladder and, if no complications exist in the upper urinary tract, it may be performed with a relatively low mortality. In carcinoma of the bladder, circumstances often exist which render such an operation more hazardous. Obstruction and infection in the upper urinary tract is more often encountered in such cases. In irremediable vesicovaginal fistulae which have not lent themselves to the usual methods of surgical correction and also in cases of extensive chronic interstitial cystitis, interference with the structure and function of the upper urinary tract occurs less frequently. Consequently, ureteral transplantation is more applicable in these cases.
We wish to present the case of a patient who was disabled with extensive chronic interstitial cystitis. In this instance a bilateral ureterosigmoidostomy was done, both ureters being placed in the rectosigmoid at the same operation.
A housewife, 53 years of age, came to the Clinic on March 3, 1939, complaining of severe dysuria, frequency, nocturia, and suprapubic distress; these symptoms had been present for ten years. The initial symptoms had been frequency and mild dysuria. However, she soon began to have some nocturia and noticed that a very small amount of urine was passed at each voiding. The urine was always very clear. A uterine suspension was recommended and carried out elsewhere. . .