title: Reconstructive surgery of the extensive ureter strictures using human dura mater allografts.
abstract: OBJECTIVE
  To present and evaluate our experiences with use of human dura mater allografts in reconstructive surgery of long ureter strictures; first human derived, collagen based, oligocellular biomaterial utilized in genitor-urinary reconstructive surgery. To describe on the basis of our experiences with dura mater preferable from a technical and biological standpoint features of biomaterial as a matrix for the ureter regeneration in this condition. We also assessed a technical aspects, suitability and efficacy of the new operative method.
  
  
  METHODS
  Between 1980 and 1992, in our search for ideal biomaterial useful for reconstructive surgery of extensive ureter obstruction we used to apply human dura mater allografts. A total of 6 females and 2 males were treated with reconstructive surgery with human dura mater allografts utilized for supplementation of the ureter wall defect. Diagnosis was based on ultrasonography, excretory urography and retrograde ureteropyelography. Imaging studies revealed obstructed ureter segment of at least 4 cm length.
  
  
  RESULTS
  In all cases procedure was completed without any complications. Hospitalization after the surgery lasted approximately 8-10 days. Early and late follow-up excretory urography demonstrated lack of obstruction in the operated ureter segment. Long term follow-up of 12 months to 18 years (meanly 8,75 years) showed no signs of renal function deterioration, without urine obstruction on the operated side in all patient. Fluoroscopy scans showed signs of peristaltic wave in the operated ureter segment.
  
  
  CONCLUSIONS
  Both a supplementary biomaterial used and a new operative method proved to be a promising option in reconstruction of long ureter strictures. Unfortunately a threat of prion related diseases, which resulted in exclusion dura mater grafts and all biomaterial originated from nervous system from transplantology, forced us to search for new suitable material.
authors.affiliation: Department of Urology, Specialized Regional Hospital in Siedlce, Poland. urologiasiedlce@wp.pl
authors.forename: Andrzej
authors.initials: A
authors.lastname: Koziak
authors.forename: Piotr
authors.initials: P
authors.lastname: Kania
authors.forename: Adam
authors.initials: A
authors.lastname: Marcheluk
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Dmowski
authors.forename: Ryszard
authors.initials: R
authors.lastname: Szcześniewski
authors.forename: Adam
authors.initials: A
authors.lastname: Dorobek
mesh_terms: D004388:Dura Mater / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*