The efficacy of transureteroureterostomy for ureteral reconstruction during surgery for a non-urologic pelvic malignancy.

OBJECTIVE: Of the many surgical options available for ureteral reconstruction during surgery for non-urologic pelvic malignancies, the efficacy of transureteroureterostomy (TUU) was investigated.

METHODS: Ureteral reconstruction was dichotomized as follows: group 1, end-to-end ureteroureterostomy and ureteroneocystostomy (UNC) with or without a psoas hitch; and group 2, TUU. TUU was preferably performed when partial bladder invasion was suspected or patients had undergone prior surgery or radiotherapy. Groups 1 and 2 included 17 and 28 patients, respectively. These patients were consecutively enrolled and analyzed with respect to complications and clinical outcomes.

RESULTS: Of the complications that followed TUU, persistent hydronephrosis and a transient urine leak were detected in one patient each. No differences in complication rates were observed between the two groups with respect to hydronephrosis, azotemia, urine leak, and acute pyelonephritis. Patients who had a UNC with a psoas hitch tended to have more frequent voiding dysfunction postoperatively than those who had a TUU.

CONCLUSIONS: TUU is a feasible technique for ureteral reconstruction when multivisceral resection, including the ureter, is performed during surgery for non-urologic pelvic malignancies. TUU could be a preferred method in patients requiring partial cystectomy or in those that have undergone prior surgery or radiotherapy.