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Updated: Feb 17, 2026
Urethral Stricture Induction Followed by Buccal Mucosa Graft Urethroplasty in a Rat Model
Published on: April 28, 2023
Robotic Ureteral Reconstruction Using Buccal Mucosa Grafts: A Multi-institutional Experience
Lee C Zhao1, Aaron C Weinberg1, Ziho Lee2
1Department of Urology, New York University, Langone Medical Center, New York, NY, USA.
Background:
Minimally invasive treatment of long, multifocal ureteral strictures or failed pyeloplasty is challenging. Robot-assisted buccal mucosa graft ureteroplasty (RBU) is a technique for ureteral reconstruction that avoids the morbidity of bowel interposition or autotransplantation.
Objective:
To evaluate outcomes for RBU in a multi-institutional cohort of patients treated for revision ureteropelvic junction obstruction and long or multifocal ureteral stricture at three tertiary referral centers.
Design, Setting, And Participants:
This retrospective study involved data for 19 patients treated with RBU at three high-volume centers between October 2013 and July 2016.
Surgical Procedure:
RBU was performed using either an onlay graft after incising the stricture or an augmented anastomotic repair in which the ureter was transected and re-anastomosed primarily on one side, and a graft was placed on the other side.
Outcome Measurements And Statistical Analysis:
Preoperative, intraoperative, and postoperative variables and outcomes were assessed. A descriptive statistical analysis was performed.
Results And Limitations:
The onlay technique was used for 79%, while repair was carried out using the augmented anastomotic technique for the remaining cases. The reconstruction was reinforced with omentum in 95% of cases. The ureteral stricture location was proximal in 74% and mid in 26% of cases. A prior failed ureteral reconstruction was present in 53% of patients. The median stricture length was 4.0cm (range 2.0-8.0), operative time was 200min (range 136-397), estimated blood loss was 95ml (range 25-420), and length of stay was 2 d (range 1-15). There were no intraoperative complications. At median follow-up of 26 mo, the overall success rate was 90%.
Conclusions:
RBU is a feasible and effective technique for managing complex proximal and mid ureteral strictures.
Patient Summary:
We studied robotic surgery for long ureteral strictures using grafts at three referral centers. Our results demonstrate that robotic buccal mucosa graft ureteroplasty is a feasible and effective technique for ureteral reconstruction.
