MP33-13 PERCUTANEOUS ANTEGERADE URETEROSCOPY FOR TREATMENT OF URETEROINTESTINAL ANASTAMOTIC STRICTURES

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy III1 Apr 2016MP33-13 PERCUTANEOUS ANTEGERADE URETEROSCOPY FOR TREATMENT OF URETEROINTESTINAL ANASTAMOTIC STRICTURES Natalia Hernandez, Patrick Gomella, Brian Matlaga, Gyan Pareek, Vernon Pais, Patrick Mufarrij, and Brian Eisner Natalia HernandezNatalia Hernandez More articles by this author , Patrick GomellaPatrick Gomella More articles by this author , Brian MatlagaBrian Matlaga More articles by this author , Gyan PareekGyan Pareek More articles by this author , Vernon PaisVernon Pais More articles by this author , Patrick MufarrijPatrick Mufarrij More articles by this author , and Brian EisnerBrian Eisner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1370AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Few studies in the literature have examined the efficacy of percutaneous antegrade ureteroscopy with balloon dilation and/or laser incision for treatment of ureterointestinal anastamotic strictures after urinary diversion. METHODS A multi-center retrospective review of longitudional medical records was performed to evaluate the success rates and characteristics of patients who formed ureterointestinal anastamotic stricture after urinary diversion and subsequently underwent percutaneous antegrade ureteroscopic treatment. RESULTS Twenty-six (26) percutaneous antegrade ureteroscopic procedures were performed with balloon dilation and/or laser incision of stricture. Mean patient age was 65.2 years (SD 27), median time between urinary diversion and treatment for stricture was 249 days (SD 2184), and mean follow-up time was 292.6 days (SD 252). Urinary diversion type was ileal conduit in 77% of cases, colon conduit in 11% of cases, Indiana Pouch in 8% of cases, and orthotopic neobladder in 4% of cases. Successful stricture treatment occurred in 24/26 cases (92.3%) and in 2 cases no treatment could be performed due to complete occlusion of the ureter. At most recent follow up, patients who underwent percutaneous antegrade ureteroscopy and stricture treatment demonstrated significant improvement in serum creatinine compared with before treatment (Cr after treatment = 1.3, Cr prior to treatment = 1.6, p = 0.04). At this follow up time, none of the 24 successful stricture dilations had undergone subsequent open or laparoscopic revision. CONCLUSIONS In patients with ureterointestinal anastamotic strictures, percutaneous antegrade ureteroscopy with balloon dilation and/or laser incision of stricture was accomplished in a majority of cases (>90%) and resulted in significant improvements in renal function. This minimally invasive procedure may be considered prior to more extensive reconstructive surgery in patients with ureteroinestinal anastamotic strictures after urinary diversion. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e441-e442 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Natalia Hernandez More articles by this author Patrick Gomella More articles by this author Brian Matlaga More articles by this author Gyan Pareek More articles by this author Vernon Pais More articles by this author Patrick Mufarrij More articles by this author Brian Eisner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...