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The unintubated ureterotomy endourologically revisited
S M Gardner1, J S Wolf, S Y Nakada
1Department of Surgery, Washington University, St. Louis, Missouri 63110, USA.
The Journal of Urology
|September 1, 1996
Summary
For secondary midureteral strictures, endoureterotomy may not require ureteral stenting. A porcine study found that unstented endoureterotomy resulted in nonobstructing dilation, suggesting stenting might be unnecessary.
Area of Science:
- Urology
- Surgical Innovation
- Animal Models
Background:
- The necessity and duration of ureteral stenting after endoureterotomy for midureteral strictures remain debated.
- A fundamental question is whether ureteral stenting is required at all following this procedure.
Purpose of the Study:
- To investigate the necessity of ureteral stenting after endoureterotomy in a porcine model.
- To evaluate the outcomes of unstented versus stented endoureterotomy for secondary midureteral strictures.
Main Methods:
- A unilateral midureteral stricture was surgically induced in 20 minipigs.
- Endoureterotomy was performed on 15 pigs; 10 received a 7F ureteral stent for 1 week, while 5 remained unstented.
- Ureters were assessed radiographically and histologically three months post-procedure.
Main Results:
- Strictures recurred in 3 of 5 control animals and 2 of 10 stented animals.
- All 5 unstented animals exhibited nonobstructing dilation at the endoureterotomy site.
- Renal scans confirmed normal furosemide washout in the 3 tested unstented animals.
Conclusions:
- Endoureterotomy for secondary midureteral strictures in a porcine model may not necessitate ureteral stenting.
- These findings suggest a potential to avoid stenting in similar clinical scenarios, simplifying post-operative care.