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Endoscopic ureteroureterostomy for obliterated ureteral segments
M J Conlin1, L G Gomella, D H Bagley
1Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Purpose:
Advances in endourological techniques and instrument design have made the endoscopic treatment of complete ureteral obstruction a reasonable alternative to open surgery. We report our experience with endourological management of 10 cases of obliterated ureteral segments.
Materials And Methods:
Endoscopic ureteroureterostomy was performed in 8 patients with complete ureteral obstruction and it was not attempted in 2 because of the length or orientation of the obliterated segment.
Results:
Access, incision and stenting of the obliterated segment were technically successful in 8 patients. Two patients had patent ureters but required a stent, including 1 who underwent nephrectomy due to problems with stent management. Endoscopic treatment achieved long-term patency in 7 of the 8 cases and it was completely successful in 6 (75%) at a median followup of 87 months (range 4 to 126).
Conclusions:
Endoscopic ureteroureterostomy is a safe and effective technique for the management of obliterated ureteral segments less than 2 cm. long with adequate alignment.