ABSTRACT
Metastasis to the ureter is a very rare complication in patients with breast cancer and bone metastases. Retroperitoneal disease appears to be an uncommon manifestation of long-standing breast cancer which is usually hormonally dependent. In most published cases, the diagnosis is only made at postmortem examination. This report presents an uncommon case of ureteral obstruction secondary to breast cancer diagnosed with ureteroscopy.
ABSTRACT
OBJECTIVE: To review our experience with laparoscopic ureterolithotomy. PATIENTS AND METHODS: Since 1993, we have performed laparoscopic ureterolithotomy in 14 patients with ureteric stones. Laparoscopy was carried out in nine patients as a salvage procedure after failed ureteroscopy (six), shock wave lithotripsy (two), or both (one), and in five patients as a primary procedure for large stones (mean 27.2 mm, range 18-40). Patients in the former group had already undergone a mean of 1.88 procedures (range 1-4). Laparoscopic ureterolithotomy was carried out via a transperitoneal approach. Associated ureteric strictures were incised at the time of ureterotomy. RESULTS: All procedures were completed laparoscopically and all patients were rendered stone-free after a single procedure. The mean operative duration was 105 min. Ureteric strictures were incised in three patients, in two of whom dilatation was subsequently required; all three had a successful result. There were three minor complications. CONCLUSIONS: Laparoscopic ureterolithotomy can be a safe and effective procedure; it should be considered as a primary procedure for large mid- and upper ureteric stones.
