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Related Experiment Videos

Lower ureteral replacement using a tubularized gastric segment.

O Muraishi1, M Yashi, Y Shioji

  • 1Department of Urology, Jichi Medical School, Tochigi, Japan.

Urology
|May 30, 2001
PubMed
Summary

Gastric segments can safely replace ureters in patients with severe bilateral ureteral stenosis after pelvic radiotherapy, improving quality of life. This approach allowed for removal of nephrostomy tubes in all cases.

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Urological research·2001

Area of Science:

  • Urology
  • Surgical Innovation
  • Oncologic Reconstruction

Background:

  • Pelvic radiotherapy frequently causes severe bilateral ureteral stenosis.
  • Ureteral strictures can necessitate complex reconstructive procedures.
  • Previous ureteral replacement strategies have limitations.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of using a gastric segment for ureteral replacement.
  • To assess the safety and efficacy of this technique in patients with post-radiotherapy ureteral stenosis.

Main Methods:

  • Retrospective review of four adult patients (3 female, 1 male) undergoing bilateral ureteral substitution with gastric segments.
  • All patients had received pelvic irradiation and required bilateral nephrostomy due to severe ureteral stenosis.

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  • Postoperative follow-up ranged from 11 to 50 months.

    • Main Results:

    • No major complications were observed.
    • Bilateral nephrostomy tubes were successfully removed in all patients.
    • Three female patients achieved successful ureteral voiding without incontinence; the male patient required self-catheterization and developed a vesicorectal fistula.

    Conclusions:

    • Gastric segment ureteral substitution is a viable option for managing severe bilateral ureteral stenosis post-pelvic radiotherapy.
    • This technique can potentially improve patient quality of life by obviating the need for long-term nephrostomy.
    • Further research is warranted to establish long-term outcomes and compare with other reconstructive methods.