Laparoscopic extravesical ureteral reimplantation for iatrogenic distal ureteral stricture.
OBJECTIVE
The authors describe their experience with laparoscopic extravesical neoureterocystostomy for iatrogenic distal ureteral stricture using a transperitoneal intracorporeal freehand suturing technique.


METHODS
Three patients with distal ureteral strictures underwent laparoscopic transperitoneal extravesical ureteral reimplantation. A 77-year-old male underwent a Lich-Gregoir antireflux ureteral reimplantation following complications arising from transurethral resection of the prostate, and two females, aged 28 and 34 years, underwent refluxing ureteral reimplantation with concurrent psoas hitch after gynecologic surgery. The authors reviewed patient records to assess peri- and postoperative outcomes following definitive laparoscopic management of stricture segments.


RESULTS
All procedures were completed entirely using a laparoscopic approach. No intra- or post-operative complications were reported. Operative times ranged between 180-250 minutes and mean blood loss was 50-150 ml. The mean time to restarting oral intake was 12 hours. Pathological evaluation confirmed benign lesions in each case and follow-up imaging confirmed satisfactory functional results.


CONCLUSIONS
Laparoscopic extravesical neoureterocystostomy for iatrogenic distal ureteral strictures is a safe and efficacious procedure. Larger cohorts and longer-term results are required before this technique is considered first-line therapy in this patient group.
Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. permpongkosol@gmail.com
Sompol
S
Permpongkosol
Anthony J
AJ
Bella
Ussapol
U
Tantarawongsa
Marshall L
ML
Stoller
D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic; D003559:Cystostomy; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D010535:Laparoscopy; D008297:Male; D012092:Replantation; D014513:Ureter / Q000473:pathology* / Q000601:surgery*