Early experience in reconstruction of long ureteral strictures with allogenic amniotic membrane.
OBJECTIVE
To present our experience with the application of human amniotic membrane for the reconstruction of extensive ureteral wall defects.


METHODS
Between 2003 and 2006, 11 patients underwent reconstructive surgery of the ureter. A human amniotic membrane allograft was used to supplement ureteral wall defects. Indications for the procedure included ureteral strictures of a 5.5 cm average (range, 3-8 cm) localized in different parts of the ureter: upper (5), middle (5) and lower (3). The etiology of ureteral loss was: postinflammatory after a complicated stone disease (5), iatrogenic (4) and idiopathic (2). Diagnosis of ureteral stricture was based on antegrade pyelography and excretory urography. Two patients had synchronous treatment for upper and middle ureteral stenosis. Treatment efficacy was assessed by excretory urography and ultrasound.


RESULTS
The mean hospitalization time was 11.9 days, mean operation time 128 min and with an average follow up of 25.2 months. Complications included: stricture recurrence (1) and symptomatic urinary tract infections (2). Excretory urography showed lack of obstruction and normal width of ureters. In one patient, residual hydronephrosis was present on ultrasound.


CONCLUSIONS
The described method seems to be a promising tool in the reconstruction of extensive ureteral strictures.
Koziak
Andrzej
A
Urology Department, Specialized Regional Hospital in Siedlce, Siedlce, Poland.
Salagierski
Maciej
M
Marcheluk
Adam
A
Szcześniewski
Ryszard
R
Sosnowski
Marek
M
D000328:Adult; D000368:Aged; D000650:Amnion / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054457:Tissue Scaffolds; D014517:Ureteral Obstruction / Q000601:surgery*