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The 'ureteroneocystostomy' seen in cross-section. FIG VI- From within the bladder, a pair of blunt edged forceps has been tunnelled upwards between the bladder mucosa and the muscle for a distance of 1.5 cms, and then passed upwards through the muscle.The spatulated donor ureter is ready to be drawn down through this tunnel by two sutures, grasped by the forceps. FIG VII-The completed operation: the distal end of the donor ureter has been brought obliquely through the bladder muscle, and now lies in a sub-mucosal tunnel; its end has been everted and anastomosed to the epithelium of the bladder wall, forming a 'nipple' uretero-cystostomy. |
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