Reimplantation of the Ureter in Prostatic Carcinoma Associated with Bilateral Ureteric Obstruction

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Abstract
Bilateral ureteric obstruction from prostatic carcinoma is not uncommon. A number of techniques for urinary diversion have been used in selected patients when uremia develops. Reimplantation of the ureter(s) as an alternative to urinary diversion has been carried out in 21 patients over a 7-yr period. In 6 of these patients bilateral reimplantation was done. In another 6 patients reimplantation of the ureter was not possible and cutaneous ureterostomy was carried out. The overall survival time was 10.6 mo. In 13 patients living more than 6 mo. post-operatively, survival time was 1.8 yr. Most patients had severe uremia and advanced (clinical stage III or IV) prostatic carcinoma. The immediate management of these patients is outlined; the importance of early diagnosis is stressed. Whenever possible, ureteric reimplantation apparently should be considered for relieving ureteric obstruction in patients selected for active treatment.