Royal College of Surgeons in Ireland
The Pull-through Anastomosis of Ureter to Enteric Conduit (PAUTEC)_ A Novel Technique for Urinary Diversion.pdf (1.05 MB)

The Pull-through Anastomosis of Ureter To Enteric Conduit (PAUTEC): a novel technique for urinary diversion

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posted on 2024-03-15, 15:25 authored by Stefanie M Croghan, Anne E Daniels, Caroline Kelly, Linda Fitzgibbon, William P Shields, Ivor M Cullen, Padraig DalyPadraig Daly

Objective: To describe and illustrate a novel technique of uretero-ileal anastomosis for use in urinary diversion - the Pull-through Anastomosis of Ureter To Enteric Conduit (PAUTEC). A second objective was to evaluate the surgical outcomes of the PAUTEC anastomosis.

Materials and methods: Our novel anastomotic technique was described step-by-step and visually depicted with illustrations and the accompanying narrated video. Additionally, to evaluate safety and efficacy, a retrospective review of a prospectively maintained database was performed. Patients who underwent radical cystectomy alone or during pelvic exenteration, with ileal conduit diversion incorporating PAUTEC, 2016-2020 with ≥6 months follow-up were included. Surgical outcomes and renal function were analysed.

Results: PAUTEC anastomosis was performed on 43 ureters in 23 patients. Mean age was 66 years [50-80] and 21 of 23 patients were male. One patient had a conservatively-managed small urine leak. No ureteric strictures have been identified to date. Mean serum creatinine was 1.15 mg/dL [0.69-2.08] (102umol/L, range 61-184 umol/L) preoperatively, and 1.09 mg/dL [0.61-2.59] (96.3 umol/L, range 54-229 umol/L) at follow-up, demonstrating no significant change (P= .26, paired t-test). Mean follow-up was 15 months [6-44].

Conclusion: A PAUTEC technique of uretero-ileal anastomosis is feasible and technically straightforward, with satisfactory outcomes observed to date



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Published Citation

Croghan SM, et al. The Pull-through Anastomosis of Ureter To Enteric Conduit (PAUTEC): a novel technique for urinary diversion. Urology. 2021;157:263-268.

Publication Date

17 July 2021

PubMed ID



  • Surgery


Elsevier B.V.


  • Published Version (Version of Record)

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