Distal ureteral replacement with tubularized porcine small intestine submucosa.
Extensive ureteral injury can result from renal stone disease, iatrogenic injury, or penetrating trauma. A significant ureteral stricture can be repaired using various techniques, including the psoas hitch, Boari flap, transureteroureterostomy, ileal ureter, or renal autotransplantation. We describe a woman with a 5-cm, ischemic uretero-Indiana pouch stricture that developed after cystectomy and urinary diversion. Severe pelvic fibrosis prevented adequate mobilization of the ureter and Indiana pouch and would not permit any of the above-mentioned procedures. We report the first human use of tubularized small intestine submucosa to successfully replace a 5-cm strictured segment of distal ureter.
O'Connor
R Corey
RC
Department of Surgery, Section of Urology, University of Chicago Hospitals, Chicago, Illinois 60637, USA.
Hollowell
Courtney M P
CM
Steinberg
Gary D
GD
D000818:Animals; D015653:Cystectomy; D006801:Humans; D007421:Intestine, Small / Q000637:transplantation*; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D013552:Swine; D014183:Transplantation, Heterologous / Q000379:methods*; D014513:Ureter / Q000601:surgery*; D014515:Ureteral Diseases / Q000209:etiology* / Q000601:surgery; D014517:Ureteral Obstruction / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods