Introduction/Background Metastatic involvement of the urinary tract in patients with advanced ovarian carcinoma can occur with hydronephrosis. In treatment, ureteroureterostomy is required. In this video presentation, we present step by step ureteroureterostomy procedure.

Methodology 62-year-old woman with ovarian cancer admitted to gynecologic oncology unit with abdominal and flank pain. Abdominopelvic computerized tomography showed grade 2 hydronephrosis in left kidney and 10 cm diameter left adnexial solid mass. At surgery, adnexial mass showed involvement in the left ureter.

Results Step 1: First step is the identification the ureter and mobilization the ureter to obtain adequate length for repair without revascularizationStep 2: The edges of both the proximal and distal ureteral segments are resected to ensure that viable tissue is being anastomosed. Step 3: Insertion of double J catheter Step 4: Both ends of the ureter are spatulated. After placement of corner sutures, the anastomosis is done in a running fashion.

Conclusion Postoperatively, the urethral catheter and wound drainage removed after seven days.