[Ureteroplasty with buccal flap: indications, technique, alternative methods]

Area of Science:

• Urology
• Surgical Reconstruction

Background:

• Ureteral reconstruction has evolved over a century, with various techniques developed for strictures.
• Buccal and tongue mucosa flaps offer a method for replacing long ureteral defects, with established feasibility since the late 20th century.

Approach:

• This literature review analyzes indications, techniques, and alternatives for ureteroplasty using buccal flaps.
• Robot-assisted buccal ureteroplasty is frequently employed, associated with high success and low complication rates.

Key Points:

• Buccal flap ureteroplasty is effective for long ureteral strictures, especially in the ureteropelvic junction and upper/middle thirds.
• This technique is suitable for defects not amenable to endoscopic procedures or simple end-to-end anastomosis.

Conclusions:

• Continued experience and multicenter studies are crucial for refining indications, contraindications, and techniques for buccal flap ureteroplasty.
• The buccal flap offers a valuable reconstructive option for complex ureteral strictures.