PATIENTS who have recurring urological symptoms following nephrectomy present a special problem to the practitioner. In many cases, nephrectomy has been done for pyohydronephrosis, calculus formation, or other obvious pathology, yet the symptoms for which the patient consulted his physician persist or sometimes recur many years after the operation. We would like to reemphasize the possibility of an abnormal or diseased remaining lower ureteral segment as a possible cause for the continued symptoms.
In conditions such as papillary carcinoma of the renal pelvis and carcinoma of the ureter, removal of the entire ureter at the time of nephrectomy is universally considered the operation of choice. But in many cases, such as nephrectomy for renal tuberculosis, pyohydronephrosis, and renal calculus formation, the advisability of total nephroureterectomy is controversial. In the past few years, interest in the fate of the ureteral stump following nephrectomy has been kindled by experimental studies1 and