[Intestinal ureteral reconstruction in a patient who underwent 14 laparotomies]

Small bowel reconstruction of the ureters is the main and universal method of restoring the patency of the upper urinary tract in patients with long strictures, especially after radiation therapy. Such surgical intervention cannot always be performed using a laparoscopic approach. In the most challenging cases, the choice lies between open reconstructive procedure and nephrectomy. We present a clinical case of a 45-year-old patient with post-radiation changes in the abdominal cavity and retroperitoneum who underwent 14 laparotomies, half of them due to peritonitis, repeated ureteral stenting, and percutaneous nephrostomies. Given the patients strong desire to preserve the kidney and the presence of a stricture of the contralateral ureter, we deemed it feasible and successfully performed an open ureteral reconstruction using ileal segment.