[Prosthetic pyelovesical and pyelocutanous bypass. A palliative therapy concept in tumor-induced chronic hydronephprosis].
METHODS
Since 2/02 to 2/03 a total of 13 patients underwent either pyelovesical bypass (10 patients) or pyelocutaneous bypass (3 patients). A composite implant, consisting of two coaxial tubes internal pure smooth silicone covered by coiled e-PTFE has been designed to serve as the ureteral replacement. This prothesis in inserted percutaneously into the renal pelvis, tunnelled subcutaneously, and introduced through a small suprapubic incision in the bladder or out directly through a cutaneous orifice.


RESULTS
One encrustation of the subcutaneous pyelocutaneous bypass was observed, no angulation or dislocation during a mean follow up of 6.2 month. Improvement in the quality of life was stressed in all patients.


CONCLUSIONS
The subcutaneous urinary division using a silicone-PTFE prothesis is an efficient and minimal-invasive technique to attend malignant obstructions of the ureter.
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery*; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000295:instrumentation*; D012826:Silicone Elastomers; D014517:Ureteral Obstruction / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014547:Urinary Diversion / Q000295:instrumentation*; D014571:Urologic Neoplasms / Q000532:radiotherapy / Q000601:surgery*
D012826:Silicone Elastomers; D011138:Polytetrafluoroethylene