[AUGMENTED ONLAY BUCCAL MUCOSAL GRAFT URETEROPLASTY FOR URETERAL STRICTURE: A CASE REPORT].

Area of Science:

• Urology
• Pediatric Surgery
• Reconstructive Urology

Background:

• Fibroepithelial polyps can cause significant urinary tract obstruction and renal damage in children.
• Previous endoscopic treatment for ureteral polyps led to intractable urethral and ureteral strictures in this patient.
• Complex reconstructive surgery was required to address the severe sequelae of polyp obstruction and iatrogenic strictures.

Purpose of the Study:

• To report a case of successful management of complex ureteral polyps with secondary strictures in a pediatric patient.
• To describe the reconstructive surgical techniques employed for urethral and ureteral strictures.
• To evaluate the long-term outcomes of surgical intervention for fibroepithelial polyps and associated strictures.

Main Methods:

• The patient underwent Palminteri urethroplasty with a penile skin graft for urethral stricture.
• Augmented onlay ureteroplasty using a buccal mucosa graft was performed for the stenotic ureter.
• Minimally invasive resection of obstructed segments and polyps was combined with reconstructive grafting.

Main Results:

• Successful reconstruction of both urethral and ureteral strictures was achieved.
• Postoperative recovery included removal of nephrostomy at 13 days and ureteral stent at 4 months.
• No evidence of recurrent strictures or polyps was found on imaging and ureteroscopy up to 2 years postoperatively.
• The patient remained well with preserved renal function 3 years after surgery.

Conclusions:

• Complex fibroepithelial polyps of the urinary tract can lead to severe complications requiring advanced reconstructive surgery.
• Urethroplasty and ureteroplasty with buccal mucosa grafting are effective in treating iatrogenic strictures secondary to polyp management.
• This case highlights the successful long-term outcome of a multi-stage reconstructive approach in a pediatric patient with a rare presentation.