Transureteroureterostomy: an adjunct to cystectomy

Eight elderly patients with carcinoma of the bladder have been managed over the last three years with cystectomy done along with transureteroureterostomy. The decision for surgery was dictated by intractable bleeding, disabling symptoms, and extensive recurrent lesions of life-threatening degree. All of these patients were a poor risk. All successfully had cystectomy with urinary diversions achieved by transureteroureterostomies in association with a cutaneous ureterostomy. The surgery was done extraperitoneally; the patients were usually ambulated quickly, and the need for long-term nasogastric tubes was obviated. The course and clinical management of these patients are discussed and advantages and disadvantages of this form of urinary diversion presented.