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Female Bladder Dysfunction Following Boari Bladder Flap Ureteral Reconstruction.
Juliet K Hardesty1, Ramzy T Burns2, Mary E Soyster2
1Indiana University School of Medicine, Indianapolis, IN.
Urology
|February 18, 2024
Summary
Boari flap ureteral reconstruction in women shows moderate rates of new lower urinary tract symptoms (LUTS), manageable with medication. This technique offers a high success rate with rare serious complications for ureteral reconstruction.
Area of Science:
- Urology
- Surgical Reconstruction
Background:
- Ureteral reconstruction is essential for managing various ureteral pathologies.
- The Boari flap is a recognized technique for bladder augmentation and ureteral repair.
Purpose of the Study:
- To evaluate the incidence of new-onset lower urinary tract symptoms (LUTS) after Boari flap ureteral reconstruction.
- To assess the overall success and complication rates of the Boari flap procedure.
Main Methods:
- Retrospective review of patients undergoing Boari flap ureteral reconstruction from 2013-2023.
- Exclusion of male patients and those with urothelial carcinoma to isolate female-specific LUTS.
- Primary outcome: new-onset LUTS and treatment; Secondary outcomes: infections and ureteral strictures.
Main Results:
- Twenty-nine female patients were analyzed, with primary indications including radiation and iatrogenic injury.
- New-onset LUTS occurred in 27.6% of patients, successfully managed with oral anticholinergics.
- Complications included infections (17.2%) and ureteral strictures (6.9%), with successful treatments.
Conclusions:
- Boari flap ureteral reconstruction is associated with moderate rates of postoperative LUTS in women.
- The procedure demonstrates a high success rate and a low incidence of severe complications.
- Boari flap with or without psoas hitch is a viable option for definitive ureteral reconstruction.
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