Urothelial-based reconstructive surgery for upper- and mid-ureteral defects: Long-term results
Barak Rosenzweig1, Yoram Mor1, Tomer Erlich1
1Department of Urology, The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
Summary
Urothelial reconstruction effectively treats upper and mid-ureteral strictures, preserving kidney function. This surgical approach demonstrates an 84% success rate, minimizing the need for re-operation.
Area of Science:
- Urology
- Surgical Reconstruction
- Nephrology
Background:
- Ureteral strictures can lead to obstructive nephropathy and kidney function decline.
- Surgical repair of upper and mid-ureteral defects poses significant challenges.
- Urothelial-based reconstructive surgery is a key approach for ureteral defects.
Purpose of the Study:
- To analyze long-term outcomes of urothelial-based reconstructive surgery for upper- and mid-ureteral defects.
- To evaluate the effectiveness of primary urothelial repair in preserving renal function.
- To assess complication rates associated with these reconstructive procedures.
Main Methods:
- Retrospective analysis of 149 patients treated for ureteral defects (2001-2011).
- Focus on 31 patients undergoing complex urothelial-based repairs for upper/mid-ureter defects.
- Median follow-up of 26 months, assessing renal function and obstruction.
Main Results:
- 84% success rate, defined by no re-operation or kidney drainage needed.
- Most lesions were benign (71%); malignant lesions accounted for 29%.
- Median GFR remained stable (66 to 64 ml/min/1.72m²); 23% experienced complications, mostly infectious.
Conclusions:
- Upper and mid-ureteral defects require specialized reconstructive surgical expertise.
- Primary urothelial-based reconstructions show promising long-term results.
- This technique is effective for complex ureteral pathologies.
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