Evaluation of the effectiveness of buccal ureteroplasty in the late postoperative period

Abstract

Surgical treatment of organic obstruction of the upper urinary tract is a complex problem in modern urology. The aim of the study was to analyze the assessment of the late postoperative period after ureteral replacement with a buccal graft. We followed up 32 patients who underwent buccal ureteroplasty (BU). The effectiveness of this surgical intervention was assessed by the absence of recurrence of the disease and the need to reuse ureteral stenting or percutaneous nephrostomy. Recurrence of urinary tract obstruction was later detected in 3 (9.4 %) patients. Also, after removal of the stent in 18 patients, the following indicators were evaluated: glomerular filtration rate, maximum systolic blood flow velocity in the interlobar arteries of the kidney, thickness of the kidney parenchyma, ureteroscopy, and pain in the lumbar region. After 6 months, the established parameters were re-determined, and in case of improvement or unchanged primary indicators, each of the parameters was scored 1 point, in case of deterioration of the primary indicators, each of the parameters was scored 0 points. If the total score is 3 or more, then the course of the postoperative period after reconstructive surgery on the upper urinary tract using a buccal graft is considered favorable and conservative therapy is continued. Two of the 18 patients had a score of 2, which led to a change in the tactics of postoperative follow-up. Thus, this method for assessing parameters in operated patients allows timely correction of renal dysfunction.