title: Combined Y-shaped common channel transureteroureterostomy with Boari flap to treat bilateral long-segment ureteral strictures.
abstract: BACKGROUND
  Ureteral stricture is a complication of several etiologies including idiopathic retroperitoneal fibrosis, infection, radiotherapy, instrumentation, and surgical procedures. A variety of techniques have been reported for management. The transureteroureterostomy and bladder flap have been the standard procedures for repairing distal ureteral defects of unilateral ureter. Bilateral ureteral stricture is an uncommon condition that challenges usual reconstructive procedures. It is a difficult task to reconstruct the complex situation of bilateral ureteral strictures.
  
  
  METHODS
  A 54-year-old female underwent concurrent chemoradiotherapy for stage IVB squamous cell carcinoma of cervix. Subsequently, she had stricture of bilateral distal ureters with bilateral hydroureteronephrosis which was found by computed tomography. The renal function deteriorated during the follow-up period. She had periodic change of double-J stents and percutaneous nephrostomy. However, the renal function still deteriorated. We performed a combined Y-shaped common channel transureteroureterostomy with Boari flap to reconstruct bilateral long-segment ureteral strictures. The patient recovered uneventfully.
  
  
  CONCLUSIONS
  Reconstruction of bilateral ureteral strictures is a difficult treatment. We developed a modified technique for the complex situation of bilateral ureteral strictures. To our knowledge, this has not been previously reported in the scientific literature and it is a feasible procedure to treat bilateral long-segment ureteral strictures.
authors.forename: Chin-Li
authors.initials: CL
authors.lastname: Chen
authors.forename: Shou-Hung
authors.initials: SH
authors.lastname: Tang
authors.forename: Tai-Lung
authors.initials: TL
authors.lastname: Cha
authors.forename: En
authors.initials: E
authors.lastname: Meng
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Tsao
authors.forename: Guang-Huan
authors.initials: GH
authors.lastname: Sun
authors.forename: Dah-Shyong
authors.initials: DS
authors.lastname: Yu
authors.forename: Sun-Yran
authors.initials: SY
authors.lastname: Chang
authors.affiliation: Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No,325, Section 2, Cheng-Kung Road, Taipei 114, Taiwan. gu2028@yahoo.com.tw.
authors.forename: Sheng-Tang
authors.initials: ST
authors.lastname: Wu
mesh_terms: D003251:Constriction, Pathologic / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013524:Surgical Flaps; D014513:Ureter / Q000601:surgery*