| Title | Terminal augmented ureteroplasty with bladder onlay flap technique for recurrent distal ureteral stricture after ureteroneocystostomy: an initial case series |
| Authors | Wu, Yucai Zhu, Weijie Yang, Kunlin Fan, Shubo Guan, Bao Huang, Bingwei Wang, Jie Wang, Jianxin Li, Zhihua Guan, Hua Huang, Yanbo Li, Zhe Zhang, Peng Li, Xuesong Zhou, Liqun |
| Affiliation | Peking Univ First Hosp, Dept Urol, 8 Xishiku St, Beijing 100034, Peoples R China Peking Univ, Natl Urol Canc Ctr, Inst Urol, Beijing, Peoples R China Peking Univ Beijing, Urogenital Dis Male Mol Diag & Treatment Ctr, Beijing, Peoples R China Emergency Gen Hosp, Dept Urol, 29 Xiba Henan Li, Beijing 100028, Peoples R China |
| Keywords | MINIMALLY INVASIVE MANAGEMENT BOARI FLAP PSOAS HITCH BENIGN |
| Issue Date | Jul-2021 |
| Publisher | TRANSLATIONAL ANDROLOGY AND UROLOGY |
| Abstract | Background: Bladder flap has been shown to be a feasible treatment for distal ureteral stenosis; this technique has been improved such that it can be used to address complex urinary tract obstructions. The purpose of the present study was to describe a surgical technique of ureteroplasty with a bladder onlay flap, which consists of a nontransecting and terminal augmented anastomosis, for repairing recurrent distal strictures of the ureter. Methods: We retrospectively reviewed 6 patients who underwent this procedure between May 2018 and November 2019. These patients were diagnosed with distal ureteral stenosis and had previously undergone ureteroneocystostomy (one with a Boari flap) but suffered recurrence of flank pain. Patient characteristics, perioperative data and follow-up outcomes were gathered. The success of the operation was judged by symptomatic relief (subjective success) and improved radiographic imaging and renal function (objective success). Results: Preoperative computed tomography urography (CTU) showed hydronephrosis in all patients: severe hydronephrosis was observed in 83.3% of patients (5/6), and moderate hydronephrosis was observed in 16.7% (1/6). The mean stricture length was 2 cm. The mean operating time, estimated blood loss and postoperative hospital stays of the six patients were 193.3 min (160-270 min), 41.5 mL (10-58 mL) and 8.2 days (6-11 days), respectively. No serious complications (Clavien-Dindo grade >= 3) occurred during or after the operations. The mean follow-up time was 24.5 months (range, 14 to 29). The objective success rate was 83.3% (5/6), and the subjective success rate was 100%. Conclusions: Our technique of ureteroplasty with a bladder onlay flap by nontransecting and terminal augmented anastomosis is feasible and improves the recovery rate after the repair of recurrent distal ureteral stenosis. Patients who have had previous unsuccessful surgeries might benefit from this approach. |
| URI | http://hdl.handle.net/20.500.11897/623294 |
| ISSN | 2223-4683 |
| DOI | 10.21037/tau-21-252 |
| Indexed | SCI(E) |
| Appears in Collections: | 第一医院 |
