Transureteroureterostomy: an adjunct to the management of advanced primary and recurrent pelvic malignancy.

BACKGROUND AND AIMS

The surgical management of advanced primary or recurrent rectal cancer may involve the lower ureter or ureterovesical junction. With unilateral involvement, reconstruction of the ureters with salvage of the ipsilateral renal function should be considered.

PATIENTS AND METHODS

With optimal exposure both ureters are visualized. The crossed ureter is incised perpendicularly and then longitudinally on its medial aspect. An anterolateral ureterotomy is made on the recipient ureter. A mucosa-to-mucosa anastomosis is completed. Stents are used selectively.

RESULTS

Eleven patients with advanced pelvic malignancy underwent this procedure. There was one major complication requiring ureteronephrectomy of the crossed system.

CONCLUSION

Transureteroureterostomy should be considered as a treatment option in patients with unilateral ureteral obstruction.