Conservative treatment of lower ureteral tumor: modified ureteroneocystostomy for upper urinary tract endoscopic control.

A total of 4 patients with transitional cell carcinoma of the lower ureter underwent distal ureterectomy and ureteroneocystostomy, and were followed by ureterorenoscopy. The ureterovesical anastomosis straightened the remaining ureter, thus, avoiding any curvature or angulation between intravesical and extravesical segments. This result made possible routine endoscopic followup of all patients, since passage of a rigid ureterorenoscope through the ureter was easy without the need for dilation. No reflux was observed after ureterovesical reimplantation and endoscopic control. The results of the modified ureterovesical anastomosis strongly favor a more conservative surgical approach to transitional cell carcinoma of the distal ureter.