Endoscopy 2008; 40(9): 769-772
DOI: 10.1055/s-2008-1077447
Case report

© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic ultrasound-guided ureterosigmoidostomy in malignant ureteral obstruction: description of a new method

E.  L.  A.  Artifon1 , E.  B.  da Silveira2 , R.  I.  Lopes3 , A.  Kumar1 , M.  S.  Bhutani4 , J.  L.  Mesquita3 , T.  Souza1 , M.  Dall’oglio3 , A.  M.  Lucon3 , D.  Couto1 , P.  Sakai1 , M.  Srougi3
  • 1Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil
  • 2Division of Gastroenterology, Portland VA Medical Center, Oregon Health and Science University, Portland, Oregon, USA
  • 3Department of Urology, University of São Paulo School of Medicine, São Paulo, Brazil
  • 4Division of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
Further Information

Publication History

submitted 9 April 2008

accepted after revision 26 May 2008

Publication Date:
30 July 2008 (online)


Malignant ureteral obstruction is a late and potentially terminal complication of pelvic malignancies such as bladder, colon, and uterine cancer [1]. Traditionally, palliation of unresectable malignant obstruction takes place with percutaneous nephrostomy, endoscopic stenting, or a combination of both, which are methods known to improve renal function and quality of life [2]. Although these techniques of urinary diversion are routinely carried out by urologists, only a fraction of patients benefit from conversion to internal drainage. Unlike their counterparts of the gastrointestinal and biliary tract, palliation of malignant extrinsic compression of the ureter with endoprosthesis is often unsuccessful, with a reported failure rate of approximately 60 % [3]. We describe a new technique, endoscopic ultrasound (EUS)-guided ureterosigmoidostomy, which aimed to relieve a malignant ureteral obstruction of a poor surgical candidate in whom prior uroendoscopic stent insertion had failed.


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E. B. da Silveira, MD 

Department of Gastroenterology
Portland VA Medical Center

3710 SW US Veterans Hospital Boulevard MC
P3GI Portland
Oregon 97239

Fax: +1-503-220-3426

Email: eda_silveira@hotmail.com