Total nephroureterectomy with ureteral intussusception and transurethral ureteral detachment and pull-through.

We describe a technique for nephroureterectomy that includes ureteral intussusception and transurethral ureteral resection and our method for transurethral ureteral pull-through. These adjuncts permit total nephroureterectomy through a single skin incision and are appropriate in all cases except in patients with known high-grade transitional cell carcinoma of the renal pelvis or ureter. In 18 cases, these techniques have been shown to be reliable, safe, and rapid; in the 14 patients under observation for five years or longer, there have been no local recurrences of tumor.