| Objective To evaluate the effectiveness of subcutaneous nephrovesical bypass carried in patients with metastatic disease, where internal ureteral stenting proved to be impossible.Methods Between January 2009 and March 2011,13 nephrovesical uretericbypasses were implanted in 11 patients with advanced metastatic dis-ease. The study group consisted of 6 women and 5 men with a mean age at the time of implantation of 63.5±7.3 yr.9 patients received a unilateral nephrovesical bypass.2 patients received a bilateral nephrovesical bypass. From the study group assembled 5 patients had colonic cancer,4 had gastric cancer,1 patient had pancreatic cancer and 1 had cervical cancer after radiotherapy. The ureteral obstruction and hydronephrosis are proved by B ultrasonic and CT scan preoperation. According to the study hydronephrosis range (3.4±1.6) cm, serum creatinine (2.83±2.06) mg/dl, serum creatinine, the renal function and the postion of bypass stents were evaluated at follow-up.Results Subcutaneous nephrovesical bypass operations were successful in all 11 patients. Mean follow-up was 8.2 mo (range from postoperation to March 2011). No acute complication was observed.7 patients died during follow-up due to progressive metastatic disease (mean 6.5mo postoperation),4 patients still alive at the end of the study, hydronephrosis range (1.6±1.4) cm, serum creatinine (1.21±0.52) mg/dl 2 weeks postoperation, all stents were in position at follow-up. All patients quality of life of all patients was improved.Conclusion This nephrovesical ureteric bypass is a simple, minimallyinvasive, and highly effective treatment for patients with hydronephro-sis resulting from advanced oncologic disease. Patients gain a betterquality of life due to increased independence and mobility during theirfinal stages of life.
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