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.