Transureteroureterostomy and terminal loop cutaneous ureterostomy in advanced pelvic malignancies.
Transureteroureterostomy was combined with terminal loop cutaneous ureterostomy, without complications, in 8 patients with advanced pelvic malignancy and a poor prognosis. Urinary diversion was palliative in all patients and followed pelvic exenteration in 4, debulking of pelvic tumor in 2 and radical cystectomy in 1, while 1 had inoperable bladder cancer. All patients had at least unilateral hydroureteronephrosis preoperatively. In each case a postoperative excretory urogram revealed significant improvement of the hydroureteronephrosis and the serum creatinine improved or stabilized. No patient had ureteral stomal stenosis or retraction. Mean survival was 5 months, with the longest survival being 1 year. Transureteroureterostomy in conjunction with terminal loop cutaneous ureterostomy is an effective technique of urinary diversion in selected patients with a poor prognosis and advanced pelvic malignancy, decreasing operative time while avoiding the morbidity associated with a ureterointestinal operation or nephrostomy.
Thrasher
J B
JB
Department of Surgery, Fitzsimons Army Medical Center, Aurora, Colorado.
Wettlaufer
J N
JN
D000328:Adult; D000368:Aged; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care; D010386:Pelvic Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D014519:Ureterostomy / Q000379:methods*; D014547:Urinary Diversion / Q000379:methods*