title: Use of a long-term metal stent in complex uretero-ileal anastomotic stricture.
abstract: Uretero-ileal anastomotic stricture is a potentially serious late complication after ileal conduit formation, with a reported incidence of 3-9%. The standard management technique is open surgical revision of the anastomosis with reimplantation of the affected ureter. This is technically challenging and has potential significant morbidity for the patient. Advances in endourological techniques now offer a variety of less-invasive treatment options, like balloon dilatation or laser ureterotomy followed by stent insertion. What happens when such open and minimally invasive techniques fail? Recently, using a combined antegrade and retrograde approach, we inserted a novel, semi-permanent, dual-expansion thermo-expandable metallic alloy stent across a recurrent ileal-ureteric stricture. We describe the technique and potential advantages of this minimally invasive method. This minimally invasive treatment option is of interest, as in contrast to other stents, it does not require routine change, and is resistant to corrosion and urothelial ingrowth, hence ensuring ease of exchange or removal if required.
authors.affiliation: Endourology and Stone Services, Barts and The London NHS Trust, West Smithfield, London EC1A 7BE, UK.
authors.forename: Mohammed N
authors.initials: MN
authors.lastname: Kabir
authors.affiliation: Endourology and Stone Services, Barts and The London NHS Trust, West Smithfield, London EC1A 7BE, UK.
authors.forename: Christian
authors.initials: C
authors.lastname: Bach
authors.affiliation: Endourology and Stone Services, Barts and The London NHS Trust, West Smithfield, London EC1A 7BE, UK.
authors.forename: Stefanos
authors.initials: S
authors.lastname: Kachrilas
authors.affiliation: Endourology and Stone Services, Barts and The London NHS Trust, West Smithfield, London EC1A 7BE, UK.
authors.forename: Faruquz
authors.initials: F
authors.lastname: Zaman
authors.affiliation: Endourology and Stone Services, Barts and The London NHS Trust, West Smithfield, London EC1A 7BE, UK.
authors.forename: Islam
authors.initials: I
authors.lastname: Junaid
authors.affiliation: Endourology and Stone Services, Barts and The London NHS Trust, West Smithfield, London EC1A 7BE, UK.
authors.forename: Noor
authors.initials: N
authors.lastname: Buchholz
authors.affiliation: Endourology and Stone Services, Barts and The London NHS Trust, West Smithfield, London EC1A 7BE, UK.
authors.forename: Junaid
authors.initials: J
authors.lastname: Masood
keywords: Anastomosis; Ileum conduit; Memokath; PCNL, percutaneous nephrolithotomy; Stent; Stricture