Step‐by‐step technique for the endoscopic treatment of ureteric stricture

Gao, Xiaoshuai; Chen, Jixiang; Wang, Wei; Liao, Peng; Di, Xingpeng; Xiao, Kan; Li, Hong; Wei, Xin

doi:10.1111/bju.15558

Cited by 13 publications

(5 citation statements)

References 12 publications

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“…All operations were performed by the same endourological skilled surgeon. The surgical procedures were similarly to our previously reported (10,11). The position and length of ureteral stricture are determined by retrograde or antegrade ureterogram (Figure 1).…”

Section: Surgical Techniquementioning

confidence: 92%

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Initial Experience of Self-Expanding Metal Ureteral Stent in Recurrent Ureteral Stricture After Ureteroplasty

et al. 2021

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Background: The aim of this prospective study was to assess the safety and effectiveness of self-expanding metal ureteral stent (MUS) for the treatment of recurrent ureteral stricture after ureteroplasty.Methods: We prospectively included 24 patients who underwent MUS implantation between February 2019 and August 2020. The inclusion criteria for the procedure were recurrent ureteral strictures after ureteroplasty. A paired T test was used to compare continuous variables before and after surgery.Results: A total of 24 patients were finally included in this study. The stricture site was most common on the proximal ureter 19 (79.2%), followed by distal ureter 4 (16.7%) and middle ureter 1 (4.2%). The median length of ureteral stricture is 2.5 (range 1–18) cm. The median operative time was 51.5 min, and the median hospital stay time after surgery was 3 days. Post-operative complication included pain 1 (4.2%), urinary tract infection 2 (8.3%) and hematuria 2 (8.3%). After a median follow-up of 12 months, 19/24 (83.3%) patients were clinically and radiologically successful. We endoscopically adjusted or exchanged the failed stents. The volume of hydronephrosis (124.7 ± 132.5 vs. 66.4 ± 73.2 cm3, P = 0.015), blood creatinine level (104.5 ± 45.4 vs. 80.1 ± 23.2 μmol/L, P = 0.044) and urea nitrogen level (6.9 ± 2.4 vs. 4.8 ± 1.5 mmol/L, P = 0.003) decreased significantly after a median follow-up of 12 months.Conclusions: MUS is a safe and effective way to manage recurrent ureteral strictures after ureteroplasty. This technique provides a new choice for the treatment of recurrent stricture.

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Section: Surgical Techniquementioning

confidence: 92%

“…When the stent was released satisfactorily, radiography was performed again to confirm the stent position and patency. The migration stents were endoscopically adjusted to the normal position or exchanged as we previous reported (11).…”

Section: Surgical Techniquementioning

confidence: 99%

Initial Experience of Self-Expanding Metal Ureteral Stent in Recurrent Ureteral Stricture After Ureteroplasty

et al. 2021

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“…Overall, 47 patients underwent endoscopic management (n=19) or reimplantation surgery (n=28). Endoscopic management group including endoscopic balloon dilation [7][8] and endoscopic holmium laser incision [9]. Following balloon dilation or initial incision, lumen patency of the stricture segment was assessed by antegrade pyelography and under direct vision.…”

Section: Study Methodsmentioning

confidence: 99%

The therapeutic analysis of benign uretero-ileal anastomotic stricture after radical cystectomy and urinary diversion.

mou,

Yao,

Liu

et al. 2024

Preprint

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Background: Benign uretero-ileal anastomotic stricture (UIAS) is a potentially serious complication following radical cystectomy (RC) and urinary diversion after RC. In order to preserve residual renal function and enhance prognosis, it is imperative to draw insights from experience and tailor individualized treatment strategies for different patients. Patients and methods: Between October 2014 to June 2021, 47 patients with benign UIAS underwent endoscopic management (n=19) or reimplantation surgery (n=28). The basic data, perioperative conditions and postoperative conditions of the two groups were compared and analyzed to evaluating the efficacy. Results: In the comparison of preoperative and postoperative clinical efficacy of the same group, the endoscopic group exhibited no significant differences in creatinine and blood urea nitrogen (BUN) levels before surgery or after extubation (P>0.05), but BUN and glomerular filtration rate (GFR) levels on the affected side showed significant differences before surgery and after extubation (P<0.05). While the laparoscopic reimplantation group didn't show significant differences in creatinine, BUN and GFR levels before surgery and after extubation (P>0.05). According to the data of postoperative clinical efficacy between the two groups, there was no significant difference in creatinine and BUN levels (P>0.05), but GFR values in the endoscopic treatment group decreased more than those in the laparoscopic reimplantation group (P<0.05). Additionally, the laparoscopic reimplantation group could remove the single J tube earlier than the endoscopic treatment group (P<0.05) with a lower recurrence rate of hydronephrosis after extubation (P<0.05), and hydronephrosis occurred earlier in the endoscopic treatment group (P<0.05). Conclusions: In our experience for the treatment of UIAS after RC combined with urinary diversion, laparoscopic reimplantation can fundamentally solve the problem of UIAS, remove the ureteral stent in a relatively short time after surgery, maintain the patency of the ureter for a long time, truly preserve the residual renal function, reduce the occurrence of ureteral restenosis and hydronephrosis, and demonstrate relatively better therapeutic outcomes in this research.

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“…Ureterostenosis is a complicated disease that is usually associated with hydronephrosis or nonfunctioning kidneys, leading to severe adverse effects and a poor quality of life, especially in patients after a kidney transplantation 1 – 3 . Conventional treatment options, including percutaneous balloon ureteroplasty, nephroureteral stenting, and surgical ureteral reconstruction have been widely applied for the treatment of benign ureteral strictures.…”

Section: Introductionmentioning

confidence: 99%

An experimental study of magnetic compression technique for ureterovesical anastomosis in rabbits

Zhang

et al. 2023

Sci Rep

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This study aimed to explore the feasibility of the magnetic compression technique (MCT) for ureterovesical anastomosis in a rabbit model with ureteral obstruction. The distal ureteral obstruction model using female New Zealand rabbits was induced by ligating the distal end of the right ureter with silk thread for four weeks. A pair of cylindrical NdFeB magnets (daughter magnet and parent magnet) with a hole in the center was used for the ureterovesical anastomosis. The daughter magnet and the parent magnet were respectively placed close to the obstruction site through the dilated proximal ureter and urethra, and then the daughter-parent magnets pair was attracted together automatically. Postoperative X-rays were taken to confirm the position of the magnets. The anastomotic stoma specimens were obtained two weeks postoperatively, and the anastomotic stoma formation was observed by the naked eye and histological staining. The operation time and the anastomotic burst pressure were measured. The ureter was significantly dilated in the fourth week after ligation, which satisfied the placement of the daughter magnet. The ureterovesical magnet placements were successfully performed in ten experimental rabbits, with an operation time of 36.5 ± 6.09 min. The parent and daughter magnets attracted each other well and were subsequently removed through the urethra two weeks postoperatively, resulting in the establishment of ureterovesical anastomosis. The anastomotic burst pressure was 147.5 ± 14.59 mmHg. Gross specimens and histological examination of the anastomotic stoma showed that the anastomotic stoma healed well. MCT is feasible and simple for ureterovesical anastomosis.

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Step‐by‐step technique for the endoscopic treatment of ureteric stricture

Cited by 13 publications

References 12 publications

Initial Experience of Self-Expanding Metal Ureteral Stent in Recurrent Ureteral Stricture After Ureteroplasty

Initial Experience of Self-Expanding Metal Ureteral Stent in Recurrent Ureteral Stricture After Ureteroplasty

The therapeutic analysis of benign uretero-ileal anastomotic stricture after radical cystectomy and urinary diversion.

An experimental study of magnetic compression technique for ureterovesical anastomosis in rabbits

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