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Abstract:
The ureter that is left in place after nephrectomy may occasionally give rise to symptoms that are often attributed to other causes. The disease may not be recognized until it is far advanced or is discovered during surgery for another illness. Fourteen diseased ureteral stumps that became symptomatic months to years after nephrectomy are described. Calculi were found in six ureters and neoplasms in five; ureteritis cystica developed in one, infection secondary to vesicoureteral reflux in one, and empyema proximal to an obstructed ectopic ureteral orifice in another. Although there are several methods of imaging the ureteral stump, the best method in the authors' view is retrograde ureterography through a 5-F ureteral catheter. The catheter is inserted during cystoscopy but the injection of contrast medium is done in a radiographic/fluoroscopic facility where carefully monitored fluoroscopic spot radiographs can be obtained.