Endoscopic ureteroneocystostomy for complete obstruction at the ureterovesical junction.
OBJECTIVE
We evaluated the technical and long-term success of endoscopic ureteroneocystostomy in patients with complete obstruction of the distal ureter.


METHODS
We treated 7 patients with complete obstruction at the ureterovesical junction via a combined antegrade and retrograde endoscopic approach (endoscopic ureteroneocystostomy). The etiology of obstruction included ureteroscopy for ureteral calculi in 3 patients and previous resection of bladder tumors or the prostate in 4. Six patients had proximal drainage with a percutaneous nephrostomy catheter at referral. An antegrade approach was used for localization, and a retrograde approach was used for direct visual ureteral meatotomy or ureterotomy with the endoscopic scissors or a cold-knife urethrotome.


RESULTS
Continuity at the ureterovesical junction was restored in all 7 patients, and 6 are currently stricture-free with followup of 14 to 64 months. The sole failure in this series was due to recurrent invasive transitional cell carcinoma.


CONCLUSIONS
Endoscopic ureteroneocystostomy is a safe and effective treatment of complete obstruction of the ureterovesical junction.
Strup
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Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Bagley
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D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003559:Cystostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D014517:Ureteral Obstruction / Q000601:surgery*; D018666:Ureteroscopy; D001743:Urinary Bladder / Q000601:surgery*