Robotic ureteral reconstruction for recurrent strictures after prior failed management

Area of Science:

• Urology
• Minimally Invasive Surgery
• Reconstructive Surgery

Background:

• Ureteral strictures often require complex management, especially after failed initial treatments.
• Recurrent strictures pose significant challenges, necessitating advanced surgical techniques.

Purpose of the Study:

• To evaluate the efficacy and safety of robotic ureteral reconstruction (RUR) in patients with recurrent ureteral strictures.
• To describe the multi-institutional experience with RUR following prior failed endoscopic and/or surgical management.

Main Methods:

• Retrospective review of the Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database (05/2012-01/2020).
• Inclusion of 105 patients with recurrent ureteral strictures post-failed management.
• Assessment of surgical success defined as absence of flank pain and obstruction on imaging.

Main Results:

• Successful RUR in 89.5% of cases at a median follow-up of 15.1 months.
• Median stricture length was 2 cm, with various locations including UPJ (41.0%) and distal ureter (35.2%).
• Low rate of major post-operative complications (1.9%).

Conclusions:

• Robotic ureteral reconstruction demonstrates good intermediate-term outcomes for recurrent ureteral strictures.
• RUR is a viable option for patients with complex strictures refractory to conventional treatments.