Percutaneous Transrenal Electro-Incision of Ureterointestinal Anastomotic Strictures: Long-Term Results and Comparison of Fluoroscopic and Endoscopic Guidance

Abstract

Combined endoscopic and fluoroscopic guidance is preferable to fluoroscopy alone. The technique is simple if the endoscope is inserted retrograde. Long-term results are satisfactory and we believe that incision should be the initial approach to strictures of uro-digestive anastomoses.

Two Thermoformable Spiral Metallic Ureteral Stents in a Patient with Ileal Conduit and Distal Stenosis of the Ureters

“…Alternatively, the endoscopic technique including electroincision of the anastomotic stricture has been described by Cornud et al [5]. The holmium:YAG laser is an ideal tool for performing endoureterotomy.…”

Ureterointestinal strictures following Bricker ileal conduit: management via a percutaneous approach

“…Approximately 4-8% of intestinal urine diversion procedures after radical cystectomy are complicated with ureterointestinal strictures [2][3][4]. Ureteroileal anastomosis strictures are usually asymptomatic and may cause significant renal damage before discovered.…”

“…Leisinger and Deyhle were the first to present a successful endoscopic incision of a stenosis at the ureteroileal anastomosis using an electric wire loop [23], while Cornud et al reported a success rate of 71% when the stricture was incised using a papillotome [3]. Poulakis et al utilized a cold-knife incision technique of the stricture at the ureteroileal anastomosis in a series of 40 patients, and reported a success rate of 60.5% with a mean follow-up period of 38.8 months.…”

“…Anastomotic strictures constitute a major concern accompanying urinary diversion techniques, occurring in approximately 4-8% of cases [2][3][4], while higher figures have been reported [5]. They pose a challenging task for the urologist and are probably the most intriguing of all types of ureteral strictures.…”

Getting out of a tight spot: an overview of ureteroenteric anastomotic strictures

“…Meretyk et al 67 and Cornud et al 68 were first to describe the use of a cutting electrode for treatment of ureteroenteric anastomotic strictures. However, their technique was limited by the need for specialist endoscopic equipment and for urologists with expertise in interventional uroradiological techniques.…”