Labial mucosal grafting onlay ureteroplasty without omental wrap for ureteral stricture with occlusion: initial results.

Abstract

The treatment of complex ureteral stricture has always been a hot and difficult topic in urology. The aim of our study is to investigate the feasibility and clinical efficacy of labial mucosal graft (LMG) onlay ureteroplasty without omental wrap for ureteral stricture with occlusion and present our initial experience. We retrospectively reviewed perioperative and follow-up data of 12 patients admitted to The First Affiliated Hospital of Chongqing Medical University who underwent the LMG ureteroplasty with ureteral occlusion from April 2022 to September 2023. After stricture and occluded segments were incised longitudinally, the LMG was used to expand the ureteral lumen without omental wrap. All patients had successful surgery with no intraoperative complications. The median length of ureteral stricture was 3.5 cm (range, 3-5 cm), the median length of the occlusion was 1.5 cm (range, 1-2 cm), the median length of the LMGs is 4.5 cm (range, 4-6 cm). Ureteroscopy confirmed that the reconstructed ureteral lumen was unobstructed except for one patient with thin film-like ureteral stricture. Only one patient had slight contracture at the graft site, which did not affect movement of lip and appearance. No persistent and obvious discomfort was observed at the graft site in the remaining patients. Our experience suggests that LMG onlay ureteroplasty without omentum wrap appears to be a feasible and safe option for reconstruction of ureteral occlusion.