Outcomes of Distal Ureteral Reconstruction Through Reimplantation With Psoas Hitch, Boari Flap, or Ureteroneocystostomy for Benign or Malignant Ureteral Obstruction or Injury

Urothelial-based reconstructive surgery for upper- and mid-ureteral defects: Long-term results

“…Wenske et al reported similar results analyzing their whole cohort, while subanalysis of their data showed that preoperative renal function, age, and gender can serve as predictive factors for renal functional deterioration. 15 Subanalyzing our own data using the same criteria indeed showed that the four of the six patients with worsening eGFR were females. However, we found no correlation with age or preoperative renal functional impairment.…”

“…Passerini-Glazel et al 11 reported a series of 74 patients with various ureteral defects, including distal lesions, while Baldie et al 13 excluded proximal strictures from their study. Simmons et al 14 reported mixed surgical approaches, including both urothelial-and non-urothelial-based reconstructions, altogether, while Wenske et al 15 have recently reported their surgical outcomes only for re-implantations and Boari flaps, excluding uretero-ureterostomies. Similarly, Mauck et al 2 reported their experience with Boari flaps for upper-ureteral strictures, probably serving as the only accurate reference for urothelial-based reconstructive surgery of upper-ureteral lesions.…”

“…Such a surgical success rate is promising and comparable to the figures reported by other groups. Defining failure by the need for re-intervention, Wenske et al 15 described a success rate of up to 88%. Similarly, Mauck et al, 2 using the same definition, reported 83% success rate for upper ureteral lesions reconstructed by Boari flap, not including uretero-ureterostomy reconstructions.…”

Metallic Ureteric Stents a cost-effective alternative in the management of Obstructed Distal Ureters

“…Surgical interventions, such as reimplantation of the ureter with psoas hitch, Boari lap or ureteroneocystostomy will re-establish drainage of urine from the kidney [1][2][3]. Creation of an orthotopic sigmoid neobladder will likewise effectively correct the obstruction and prevent permanent damage to renal function [4].…”

“…Creation of an orthotopic sigmoid neobladder will likewise effectively correct the obstruction and prevent permanent damage to renal function [4]. However, although initial results with reimplantation tend to be satisfactory, the eGFR deteriorates signi icantly over time in male patients [2]. Orthotopic neobladders have an early complication-rate of 22.6% and a late complication-rate of 25% [4].…”