Total proximal ureter substitution using buccal mucosa.

Area of Science:

• Urology
• Surgical Innovation
• Regenerative Medicine

Background:

• Long proximal ureteral strictures pose significant reconstructive challenges.
• Existing treatments like ileal interposition and autotransplantation have limitations.
• Buccal mucosa is well-established in urethroplasty but rarely used for ureteral reconstruction.

Observation:

• A 64-year-old female patient with Crohn's disease and comorbidities presented with a long proximal ureteral stricture.
• She underwent successful total ureteral substitution using buccal mucosa.
• Postoperative isotope scans demonstrated improved renal function.

Findings:

• Buccal mucosa grafting achieved successful total substitution of a long proximal ureteral segment.
• The procedure resulted in improved renal function post-surgery.
• This case highlights the potential of buccal mucosa in complex ureteral reconstruction.

Implications:

• Buccal mucosa may be a viable, low-morbidity alternative for select ureteral reconstruction cases.
• Further research into buccal mucosa for ureteral repair is warranted.
• This approach could expand reconstructive options for challenging ureteral strictures.