Endo-ureteroplasty with a free urothelial graft.
Endo-urological therapy for ureteral strictures is usually limited to lesions 1 cm. or shorter. In an attempt to develop an endo-urological approach to treat longer ureteral strictures, we studied the clinical use of a transurethrally harvested free graft of bladder urothelium placed into the incised stricture bed. A total of 6 patients with ureteral strictures 1.5 to 8 cm. long (average 2.9 cm.) underwent endo-surgical management via free urothelial graft endo-ureteroplasty. Operative time averaged 5.5 hours. Complications included urinoma in 1 patient, hyponatremia in 1 and a postoperative renal pseudoaneurysm in 1. Four patients had long-term (that is 22 months or longer) successful results. Free urothelial graft endo-ureteroplasty, while tedious, may be a useful endo-surgical technique for treatment of long ureteral strictures.
Urban
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DA
Department of Surgery (Division of Urology), School of Medicine, University of Alabama at Birmingham.
Kerbl
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K
Clayman
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RV
McDougall
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D000328:Adult; D000368:Aged; D004848:Epithelium / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D015607:Stents; D014182:Transplantation, Autologous; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D001743:Urinary Bladder