Outcomes Following First-line Endourologic Management of Ureteroenteric Anastomotic Strictures After Urinary Diversion: A Single-center Study

Urology. 2017 Apr:102:38-42. doi: 10.1016/j.urology.2016.10.009. Epub 2016 Oct 17.

Abstract

Objective: To assess the outcomes of patients following a first-line systematic endourologic procedure used to treat ureteroenteric anastomotic strictures (UEAS).

Materials and methods: All data from patients treated using a first-line endourologic approach for UEAS between 2010 and 2015 were reviewed retrospectively. The following data were analyzed: age, type of urinary diversion, initial symptoms, surgical endoscopic approach (antegrade or retrograde), pre- and postoperative creatinine levels, and postoperative complications and outcomes. Follow-up visits occurred at 6 weeks, 3 months, and 6 months postoperatively, and at least annually thereafter.

Results: A total of 27 patients (median age: 62.5 years) were included. Overall, 28 UEAS were treated endoscopically (ileal conduit: n = 25; neobladder: n = 3). Most UEAS developed following radical cystectomy for bladder cancer (n = 19). Overall, the endoscopic approach was successful in 20 cases (71.4%). The UEAS length was >1 cm in 21 cases (75%). All UEAS of <1 cm were treated successfully (n = 7). There were three grade II and five grade III complications. The median follow-up period was 25 months. The median creatinine levels before surgery and at last follow-up were 1.3 mg/dL and 0.9 mg/dL, respectively.

Conclusion: An endourologic procedure is a reasonable option for first-line treatment for UEAS and has promising functional outcomes and limited morbidity.

MeSH terms

  • Adolescent
  • Adult
  • Anastomosis, Surgical
  • Constriction, Pathologic / surgery
  • Female
  • Humans
  • Ileum / surgery*
  • Male
  • Postoperative Complications / surgery*
  • Retrospective Studies
  • Treatment Outcome
  • Ureter / surgery*
  • Ureteroscopy
  • Urinary Diversion*
  • Young Adult