[Results of ureterocystoneostomy for inner urinary diversion in locally advanced prostate carcinoma].
Ureterneoimplantation (unilateral in 6 cases) was performed as palliative urinary diversion in 8 patients (age 64-81 years) due to locally advanced prostate cancer and bilateral ureteral obstruction (serum creatinine 2.1 to 9.8 mg. per dl.) between 1991 and 1995. In these cases the application of a double-J-catheter had failed or a percutaneous nephrostomy was refused. Postoperative time of survival (237 days, 2 patients still living for 20 and 21 months after therapy), mortality (1 of 8 patients), morbidity and time to hospital discharge (26 days) are compared to the results of the published retrospective investigations concerning percutaneous nephrostomy. The opportunity of a natural micturition without external urinary diversion could be gained for a longer period of time (5 and 20 months) in 2 of 3 patients. The other patients with in situ double-j-catheters were drained sufficiently by a suprapubic cystostomy (serum creatinine postoperatively 1.3 to 2.0 mg. per dl.). Bilateral ureterocystoneostomy being more invasive than unilateral diversion showed no benefits and was no more performed since 1991. Uretemeoimplantation with comparable postoperative results to percutaneus nephrostomy seems to be a sufficient therapeutic possibility in patients with natural micturition, repeated catheter complications, refusal or failure of alternative urinary diversion.
Wawroschek
F
F
Klinik für Urologie und Kinderurologie, Krankenhaus Düren.
Hamm
M
M
Rathert
P
P
D000368:Aged; D000369:Aged, 80 and over; D003559:Cystostomy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D007902:Length of Stay; D008297:Male; D010166:Palliative Care; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D014513:Ureter / Q000473:pathology / Q000601:surgery; D014517:Ureteral Obstruction / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*