Single ileal segment in a cat-tail configuration for bilateral ureteric strictures

Area of Science:

• Urology
• Surgical Reconstruction
• Nephrology

Background:

• Bilateral long length ureteric strictures present significant management challenges with limited reconstructive options.
• This report details the experience with a novel approach using a single ileal segment for reconstruction.

Purpose of the Study:

• To evaluate the feasibility and safety of using a single ileal segment for bilateral long ureteric stricture reconstruction.
• To assess the impact on renal function, surgical success, and complications.

Main Methods:

• Retrospective analysis of 5 cases undergoing ileal interposition in a cat tail configuration for bilateral long ureteric strictures (2015-2020).
• Evaluation of renal function (serum creatinine), surgical success (asymptomatic, no hydronephrosis, prompt drainage), urinary tract infections, and complications.

Main Results:

• The average patient age was 42.8 years; all cases were secondary to gynecological interventions.
• Mean follow-up was 28.6 months; mean hospital stay was 14.4 days.
• No deterioration in renal function was observed; mean serum creatinine remained stable post-operatively. Post-operative complications included ileus (2), deep venous thrombosis (1), and pyelonephritis (1).

Conclusions:

• Simultaneous bilateral ileal replacement using an ileal segment in a cat-tail configuration is a feasible and safe surgical option.
• This technique is effective for medium-term preservation of renal function and provides a good conduit for urinary drainage.