Robotic Buccal Mucosa Graft Ureteroplasty: A Decade of Experience From a Multi-institutional Cohort

To characterize a large cohort of patients undergoing robotic buccal mucosa graft ureteroplasty (RU-BMG), determine the technique's durability, and assess the impact of patient- and disease-specific factors on outcomes.

We conducted a retrospective review of a multi-institutional database of robotic ureteral reconstruction for patients undergoing RU-BMG. Surgical success was defined as freedom from additional interventions for recurrent ureteral stenosis, such as stent placement, balloon dilation, or further attempts at reconstruction.

One hundred sixty-nine patients underwent RU-BMG over a 10-year period; of these, 163 met inclusion criteria for analysis. Median stricture length was 3.0 cm (IQR 2.0-4.0) and 77/163 (47.2%) patients had prior attempts at stricture treatment. Over a median follow-up duration of 29 months (12-56), 150/163 (92.0%) patients remained free from additional interventions. Median time to failure was 10.2 months (4.4-21.2). No factors were found to be independent predictors of surgical success, including stricture length, prior stricture treatment, or anastomotic technique. Limitations included a retrospective study design and low failure rate, which may have obscured the detection of statistically significant differences between groups.

In our updated multi-institutional series, RU-BMG retained excellent and durable surgical outcomes. RU-BMG should be considered as an initial management option for patients with ureteral strictures.