Long-term follow-up of ureteroplasty with different methods for long ureteral stenosis: A Single Institution Study

Abstract

Abstract Background Surgical management of long ureteral stenosis is challenging. We describethe different modalities used in our center to treat long ureteral stenosis and report ourlong-term results. Methods This is a 17-year retrospective study to evaluate the efficacy of ureteroplasty with different surgical procedures in 12 patients with long ureteral stenosis. This study has passed ethical approval. Data were collected between May 2005 and September 2021. The mean age was 41 years. Recurrent stenosis was treated with long-term ureteral stent placement. The main observation index was the success rate of surgery. The secondary index was the rate of surgical complications and recurrent stenosis. The mean is used to describe parametric continuity variables, and the median and quartile range (IQR) are used to describe nonparametric continuity variables. Results Twelve patients were included. There were iatrogenic injuries in nine patients (75%), bilateral polyps in one (8.3%), ureteral occupation in one (8.3%), and unknown origins in one (8.3%). Ileal replacement was performed in three (25%) patients, lingual mucosa grafts in four(33.3%) patients, and boari bladder flaps in five (41.7%) patients. One of the surgeries was performed laparoscopically. The median follow-up was 49 months (range 8-204), and three patients (25%) had major postoperative complications. One patient’s treatment failed, requiring special reintervention, and two patients (16.7%) underwent ureteral stent placement. We accept the limitations of this small retrospective single-surgeon series, where the surgeon had a certain surgical selection preference. Conclusion Iatrogenic injury is the most common cause of long ureteral stenosis.There are many surgical methods for ureteral reconstruction, and the boari bladder flap is a preferred method for repairing long ureteral stenosis due to fewer postoperative complications and a low treatment failure rate.