[Prosthetic replacement of the ureters]

Area of Science:

• Urology
• Oncology
• Biomaterials Science

Context:

• Malignant diseases frequently necessitate ureteral intervention.
• Ureteral reconstruction presents surgical challenges, particularly in advanced cancer cases.
• Existing methods for ureteral replacement have limitations.

Purpose:

• To evaluate the long-term reliability and efficacy of silicone prostheses for ureter replacement.
• To assess the complication rates and functional outcomes associated with silicone ureteral prostheses.
• To determine the suitability of silicone prostheses for patients with advanced malignant diseases.

Summary:

• A 20-year study involved 38 patients (30 female, 8 male, mean age 71) receiving 41 silicone ureteral prostheses for malignant conditions.
• Early complications included ureteral fistulas (16%), primarily in patients with pre-existing fistulas or bladder metastases.
• No secondary fistulas or obstructions occurred; kidney destruction was linked to pre-existing renal impairment. Prostheses remained permeable beyond 5 years.

Impact:

• Silicone ureteral prostheses demonstrate reliability and durability, offering a viable solution for ureter replacement.
• Preservation of renal function through these prostheses can enhance survival duration and quality in cancer patients.
• These prostheses are best indicated for advanced malignancies in patients with a reasonable life expectancy.