Ileocalicostomy Ureteral Substitution for Complex Ureteropelvic Junction Stricture: Technique and Initial Experience

Urology. 2018 Dec:122:174-178. doi: 10.1016/j.urology.2018.08.024. Epub 2018 Aug 29.

Abstract

Objective: To present our novel surgical technique, ileocalicostomy ureteral substitution, for the management of long upper ureteral strictures in patients without a dilated extra-renal pelvis.

Materials and methods: Two patients were identified with long, complex proximal ureteral strictures who were treated with our novel surgical technique by a single surgeon at a single institution. Perioperative data for these two patients are presented along with a detailed description of the surgical technique.

Results: Ileocalicostomy ureteral substitution was successfully performed in two cases. The total operative time for these cases was 436 minutes and 246 minutes, with estimated blood loss of 300 mL and 200 mL. Length of stay for the two patients was 8 days and 6 days, respectively. There were no major (Clavien-Dindo Classification ≥ grade 3) complications. Both patients are entirely free of urinary tubes with unobstructed kidneys since reconstruction.

Conclusion: Ileocalicostomy ureteral substitution is a feasible reconstructive option for select patients. To our knowledge this report is the initial experience in the literature presented.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / surgery
  • Female
  • Humans
  • Ileum / surgery*
  • Kidney Calices / diagnostic imaging
  • Kidney Calices / pathology
  • Kidney Calices / surgery*
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Salvage Therapy / methods
  • Treatment Outcome
  • Ureter / diagnostic imaging
  • Ureter / pathology
  • Ureter / surgery
  • Ureteral Obstruction / diagnostic imaging
  • Ureteral Obstruction / surgery*
  • Ureteroscopy
  • Ureterostomy / methods*
  • Urography