Retroperitoneoscopic cutaneous ureterostomy

A 56-year-old woman presented with bilateral ureteral stenosis and a vesicovaginal fistula secondary to advanced cervical carcinoma. Due to the long-standing obstruction she had a non-functioning right kidney. As a first step the function of the contralateral kidney was restored by percutaneous nephrostomy; two months later endoscopic cutaneous ureterostomy was performed using a four-port retroperitoneal approach. The ureter was mobilized, transected and pulled out through a 10-mm trocar in the mid-clavicular line. The total operative time was 165 min with an estimated intraoperative blood loss of less than 30 ml. Convalescence was short.