SEPARATED PYELOCOLOCUTANEOUS DIVERSION AFTER BILATERAL URETERECTOMY AND RADICAL CYSTECTOMY FOR TRANSITIONAL-CELL CARCINOMA

Objectives, To report a technique for excision of bilateral ureteral t ransitional cell carcinoma which preserves renal function and provides ready access for endoscopic follow-up and therapy of the renal pelvis . Methods, The operative procedure of bilateral ureterectomy with cons truction of a separated pyelocolo-cutaneous diversion utilizing transv erse colon is described and the clinical course of 4 patients is repor ted. Results. All 4 patients maintained excellent renal function and n ormal Electrolytes. Conduit urine cytologic studies and renal pelvis e ndoscopic examinations have remained normal. Parastomal herniation was the most frequently observed postoperative complication. Conclusions, This approach is well suited for the treatment of bilateral ureteral transitional cell carcinoma. Long-term complications are minimal and r enal function is preserved. Periodic endoscopic visualization of each renal pelvis with resection and fulguration and/or instillation of imm unotherapeutic or chemotherapeutic agents for recurrent renal pelvic l esions is readily accomplished. (C) 1997, Elsevier Science Inc. All ri ghts reserved.