Renal colic secondary to ureteral metastasis: Rare presenting manifestation of prostate cancer

Objective:  Ureteral metastasis of prostate cancer is a very rare pathology, that can be confused with an upper urinary tract urothelial carcinoma, with great implications in the surgical management and therapy of the disease. Case: A 56-years old male patient admitted to the emergency room with 2 weeks history of left flank pain without low urinary tract symptoms or hematuria. PSA level was 43,4 ng/ml. The patient underwent prostate needle biopsy and ureteral biopsy using flexible ureteroscopy, after the Lich-Gregoire ureterovesical reimplantation. In this case, renal colic as the first symptom of a ureteral metastasis secondary to prostate cancer is extremely rare which diagnosed in the patient. Conclusion: Neoureterocystostomy is a safe and effective treatment for ureteral obstruction due to prostate cancer metastasis, with low morbidity and significant benefits in terms of quality of life for patients with life expectancy more than 10 years.