Ureteral Healing Research Articles

MP05-10 NATURAL HISTORY OF URETERAL INJURY IN AN IN-VIVO PORCINE MODEL

You have accessJournal of UrologyCME1 Apr 2023MP05-10 NATURAL HISTORY OF URETERAL INJURY IN AN IN-VIVO PORCINE MODEL Sohrab N. Ali, Paul Piedras, Seyed Amiryaghoub M. Lavasani, Seyed Hossein H. Sharifi, Antonio R. H. Gorgen, Andrei D. Cumpanas, Yi Xi Wu, Zachary E. Tano, Pengbo Jiang, Roshan M. Patel, Jaime Landman, and Ralph V. Clayman Sohrab N. AliSohrab N. Ali More articles by this author , Paul PiedrasPaul Piedras More articles by this author , Seyed Amiryaghoub M. LavasaniSeyed Amiryaghoub M. Lavasani More articles by this author , Seyed Hossein H. SharifiSeyed Hossein H. Sharifi More articles by this author , Antonio R. H. GorgenAntonio R. H. Gorgen More articles by this author , Andrei D. CumpanasAndrei D. Cumpanas More articles by this author , Yi Xi WuYi Xi Wu More articles by this author , Zachary E. TanoZachary E. Tano More articles by this author , Pengbo JiangPengbo Jiang More articles by this author , Roshan M. PatelRoshan M. Patel More articles by this author , Jaime LandmanJaime Landman More articles by this author , and Ralph V. ClaymanRalph V. Clayman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003216.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroscopy (URS) accompanied by passage of a ureteral access sheath (UAS) is a common procedure for the treatment of urolithiasis; however, the ureter may sustain an injury during UAS placement. The post-ureteroscopic lesion scale (PULS) is a validated scoring system for endoscopic detection of ureteral injury. PULS Grade 3 (perforation with less than 50% partial transection) and Grade 4 (greater than 50% partial transection) are considered severe injuries generally requiring prolonged stent placement. The natural history of these lesions if left unstented, is unknown. METHODS: Female Yorkshire pigs underwent ureteral sizing with Cook® urethral dilators (10-24 Fr) using a validated force sensor with forces limited to < 6 N; passage of the urethral dilators resulted in PULS Grade ≥3 in 13 ureters. These animals were excluded from the original study but were survived for another week without stent placement. On the seventh day, URS was performed to assess ureteral healing and PULS grade. Exact fisher test and Two-Tailed T-test were used to evaluate differences in PULS grade, location (proximal, mid, or distal) and number of dilator passages. RESULTS: Among thirteen PULS lesion Grades ≥3 (nine Grade-3 and four Grade-4) in 10 pigs, URS one week later revealed healing in ten ureters (77%) (nine Grade-0 and one Grade-2) (Figure 1); however, three ureteral strictures were noted, all associated with prior Grade-3 lesions (23%). In addition, there was no difference in the location of primary lesions becoming strictures (50% in proximal, 0% in medial and 33% in distal, p=0.2133). Ureters without stricture formation had a higher mean number of dilator passages compared to those that did not stricture, (5.2 vs 3.0, p=0.0374). CONCLUSIONS: Despite PULS 3 or 4 lesions, in the absence of ureteral stenting, the urothelium in 75% of ureters healed completely within a week. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e47 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sohrab N. Ali More articles by this author Paul Piedras More articles by this author Seyed Amiryaghoub M. Lavasani More articles by this author Seyed Hossein H. Sharifi More articles by this author Antonio R. H. Gorgen More articles by this author Andrei D. Cumpanas More articles by this author Yi Xi Wu More articles by this author Zachary E. Tano More articles by this author Pengbo Jiang More articles by this author Roshan M. Patel More articles by this author Jaime Landman More articles by this author Ralph V. Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...

Design of a fully intraureteral stent and proof-of-concept in vivo evaluation.

BackgroundUreteral stents are employed regularly to facilitate urine drainage and ureteral healing in a wide variety of endourological procedures, associated mainly with ureteral stone obstruction. However, stent use frequently impairs patient quality of life, which is generally attributed to the presence of anchoring stent curls in the bladder and/or kidney. The purpose of this study was to examine the potential effectiveness and safety of a newly designed, fully intraureteral stent, in an initial proof-of-concept in vivo evaluation.Methods“Yoticurl” stents were synthesized from copolymeric, commercially-available ureteral stents. A first test to confirm the intended expansion of the spiral curls in a ureter was performed on a pig cadaver. Subsequently, a preliminary in vivo evaluation in a single pig model was completed to test stent viability, over a period of 25 days. Two stents were inserted to fully intraureteral positions into the two ureters, by standard human endourological procedure. Daily observational checks of the pig, and regular radiographic analyses were performed; the animal was then euthanized and examined by explorative laparotomy, followed by histological analysis of kidney, ureter and bladder tissue samples.ResultsThe pig displayed normal activity, appetite and sleep patterns, and radiography indicated free flow of urine, and no significant stent migration nor anatomical abnormalities. Subsequent histology found only mild inflammation in the ureter.ConclusionsThe innovative stent design tested here, if ultimately proven safe and effective for human use, may offer an alternative to currently available stents for multiple indications.

MP53-19 FEASIBILITY OF DRUG-ELUTING BIODEGRADABLE STENT FOR URETERAL STRICTURE TREATMENT IN AN ANIMAL MODEL

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II (MP53)1 Sep 2021MP53-19 FEASIBILITY OF DRUG-ELUTING BIODEGRADABLE STENT FOR URETERAL STRICTURE TREATMENT IN AN ANIMAL MODEL Wai-Nga Chan, Dong-Ru Ho, Chih-Shou Chen, Wei-Yu Lin, Yun-Ching Huang, Jian-Hui Lin, Kuo-Tsai Huang, and Yu-Liang Liu Wai-Nga ChanWai-Nga Chan More articles by this author , Dong-Ru HoDong-Ru Ho More articles by this author , Chih-Shou ChenChih-Shou Chen More articles by this author , Wei-Yu LinWei-Yu Lin More articles by this author , Yun-Ching HuangYun-Ching Huang More articles by this author , Jian-Hui LinJian-Hui Lin More articles by this author , Kuo-Tsai HuangKuo-Tsai Huang More articles by this author , and Yu-Liang LiuYu-Liang Liu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002083.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fibrosis plays an important role in ureteral stricture. The aim of the present study is to evaluate the effectiveness and histopathological sequela of a rapamycin drug-eluting biodegradable ureteral stent for treatment of ureteral stricture using a rabbit model. METHODS: Dose dependent effect of rapamycin on ureter component cell lines are tested. Fibrogenic signaling proteins, including a-SMA and Smad was evaluated with or without TGF-b co-treatment. Upper ureter fibrosis was induced by open surgery with thermal injury male rabbits. Biodegradable stents, with or without rapamycin drug eluting, were inserted. Gross anatomy changes, along with collagen deposition were evaluated with Masson’s trichrome stain. Smad, a-SMA, and SNAI 1 expressions were checked by immunohistochemistry and Western blotting 4 weeks after the operation. RESULTS: COL3A1 is the major collagen subtype depositing in rabbit ureteral healing process. Its deposition decreased in ureter thermal injury groups with or without drug-eluting stents. Rapamycin-eluting biodegradable stent can affect TGF-b and EMT signaling pathway by significantly modifying Smad and SNAI 1 expression, respectively. Hydronephrosis was severe in thermally injured ureter without stents. Once stents are in place and effective, only pelvicectasis would be found. However, the gross and histopathology of ureter remained similar between stented groups with or without drug-eluting, but they are significantly different compared to sham operated controls. CONCLUSIONS: Intralumenal administration of rapamycin by implanting bioresorbable scaffold may modify associated signaling pathway. mTOR inhibitor, applying with other effective chemicals, may be a promising way to prevent ureteral stricture after thermal injury. Source of Funding: This work was supported by grants from the Chang Gung Medical Foundation, Grant Number CMRPG6C0313, CMRPG6G0381, and CMRPG6H0551 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e946-e947 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wai-Nga Chan More articles by this author Dong-Ru Ho More articles by this author Chih-Shou Chen More articles by this author Wei-Yu Lin More articles by this author Yun-Ching Huang More articles by this author Jian-Hui Lin More articles by this author Kuo-Tsai Huang More articles by this author Yu-Liang Liu More articles by this author Expand All Advertisement Loading ...

Experimental Assessment of New Generation of Ureteral Stents: Biodegradable and Antireflux Properties.

Objective: The aim was to assess a new biodegradable and antireflux intraureteral stent (BraidStent®) design in a swine model after ureteral laparoscopic operation. Materials and Methods: A total of 24 female pigs underwent initial endoscopic, nephrosonographic, and contrast fluoroscopy assessment of the urinary tract. Afterward, unilateral ureteropelvic junction obstruction was performed by laparoscopic approach. Six weeks later, the animals underwent laparoscopic Anderson-Hynes pyeloplasty, and were randomly assigned to Group-I, in which a double-pigtail ureteral stent was inserted for 6 weeks, or Group-II, in which a BraidStent®, a biodegradable intraureteral stent design, was placed. Follow-up assessments were performed at 3 and 6 weeks and 5 months. Results: In terms of therapeutic success, complete resolution was observed in 91.6% of Group-I animals and 88.8% in Group-II. No evidence of vesicoureteral reflux (VUR) was observed in Group-II animals and statistical significance in VUR and ureteral orifice damage were observed between groups. BraidStent® degradation occurred in a controlled manner between 3 and 6 weeks, without obstructive fragments. Distal ureteral peristalsis was maintained in 66.6% and 83.3% in Group-II at 3 and 6 weeks of follow-up, respectively. In Group-II, the positive bacteriuria rate was 41.6% and the migration rate 25%. Pathological assessment showed a significant improvement in ureteral healing in Group-II vs Group-I. Conclusions: The results of this comparative study in a porcine model indicate that the intraureteral BraidStent performed similarly to conventional ureteral stents. It avoids complete ureteral length intubation, the adverse effects associated with conventional ureteral stents, and maintains a high level of distal ureteral peristalsis. Moreover, the BraidStent® exhibited a predictable and controlled degradation rate and did not cause any obstructive fragments. However, further studies are needed to improve the anchoring system and reduce the risk of bacterial colonization.

Percutaneous and Transurethral Lithotripsy for Forgotten Ureteral Stents

Dear Editor, Ureteral stents are being used more commonly in the daily urological practice. They are functionally used to re-establish or maintain the patency of the ureter and are used to relieve ureteral obstruction, promote ureteral healing following surgery, and to assist with ureteral identification during pelvic surgery. Ureteral stents passively dilate the ureter; urine flows through the center of the hollow stent as well as around the stent, facilitating the passage of debris. Stent insertion initially increases ureteral peristaltic activity, but with time, the frequency and amplitude of ureteral peristalsis decreases (1, 2). Ureteral stent placement is associated with some degree of morbidity in the majority of patients that ranges from generalized urinary discomfort to urinary tract infection or obstruction. Much of the morbidity is related to the biocompatibility of the materials used to fashion the stent and, to some extent, their design; unfortunately, the ideal stent has yet to be discovered. Despite advances in technology and communication skills, unintentionally forgotten ureteral stents represent as challenging cases, and interesting series are still being reported in the literature (3). Patients with forgotten stents may present with stone formation around stent material, severe infections, obstruction and even renal failure. Fortunately, combined endourological procedures are highly satisfactory in successful and safe management of these forgotten stents, as recently reported in the series by Rabani (4). A detailed radiological evaluation, either with preoperative CT scans and/or preoperative ascending pyelography, is highly mandatory in the management of forgotten stents, since the stone burden at tip and the top of the stent has to be evaluated. Otherwise, aggressive traction of any part of the stent in order to remove it may cause more severe complications. Furthermore, a complete endourological set-up is necessary in the minimally invasive management of forgotten ureteral stents, including ureteroscope, nephroscope and intracorporeal lithotripters. A main element of the treatment strategy is to keep the number of interventions as low as possible (5). Although not used by Rabani, a flexible ureterorenoscope with a holmium laser for retrograde intrarenal surgery may also be very useful in the management of forgotten stents and may eliminate the need for percutaneous renal approach in order to remove the fragments in the upper urinary tract. However, it should be kept in mind that laser may be harmful to the integrity of the stent and may cause fragmentation of the stent. Finally, as underlined by Rabani, the best treatment is prevention and it can be achieved by informing the patient in detail and programming an effective recall system (4).

A More “Conventional” Way to Perform Percutaneous Endopyeloplasty: A Feasibility Study

Percutaneous endopyeloplasty is a horizontal suturing of the endopyelotomy incision via a unique percutaneous tract. We present a feasibility study of our technique of percutaneous endopyeloplasty using a conventional suture with a laparoscopic needle holder via the nephroscope. A longitudinal endopyelotomy incision is performed through a 24-Fr working sheath placed via an upper calyx. Then an initial suture is placed, approximating the endopyelotomy incision distal and proximal apex, using a conventional absorbable 13-mm needle suture with a lengthened 3.5-mm pediatric laparoscopic needle holder, via the nephroscope. If possible, an additional 2 sutures are eventually placed, 1 on either side of the initial midline suture. Percutaneous endopyeloplasty, using a conventional suture with a pediatric laparoscopic needle holder via a nephroscope, is technically possible, reproducible, and effective, and was performed in 10 consecutive patients. The tissue approximation provides a fast, full thickness ureteral healing. Endopyelotomy horizontal suturing leads to a wider caliber reconstruction of the ureteropelvic junction. Percutaneous endopyeloplasty is a promising technique. Our procedure for endopyeloplasty is technically feasible and effective, with little need for highly specialized equipment. However, further technical experience and longer follow-up in a larger group of patients are necessary for more development of this technique.

New Combined Approach in Metallic Ureteral Stenting to Avoid Urothelial Hyperplasia: Study in Swine Model

We assessed the therapeutic value of a new treatment option for ureteral strictures that may avoid urothelial hyperplasia, which is the main cause of metallic stent failure. We used 24 pigs in this study. An experimental model of ureteral stricture was induced in all animals. Obstruction was confirmed by ultrasound and retrograde ureteropyelogram 6 weeks after model creation. The pigs were then randomly allocated to 2 experimental groups. Therapy involved placement of a 6 × 30 mm metallic ureteral covered stent in the ureteral stricture in group 1 and subsequent endoureterotomy at the ureteral segments adjacent to the 2 ends of the stent in group 2. A double pigtail stent was then deployed for 3 weeks. Completion studies 6 months after therapy included retrograde ureteropyelogram, endoluminal ultrasound and ureteroscopy to assess urothelial hyperplasia formation. At the end of the study evidence of urothelial hyperplasia was seen in 50% of the pigs in group 1 and in 29% in group 2. Four and 2 cases of cranial stent migration in groups 1 and 2, respectively, were seen at 6 months. Hyperplasia and renal involvement were statistically significantly different between the groups with more damage in group 1 than in group 2. Hyperplasia was markedly reduced when ureteral peristalsis was inhibited by endoureterotomy at the area of interaction between the stent and the ureter.

Tratamiento endourológico de estenosis ureterales. Estudio experimental comparativo

Objectivesto compare efficacy and efficiency of two different endourological therapies for ureteral stricture, and to evaluate pathological reactions of the ureters following both endourological techniques. Material and methodsTen pigs underwent experimental induction of ureteral stricture. Four weeks later, ureteral strictures were demonstrated by imaging techniques. Animals were divided in two groups, according to the received therapy:-Group I. (5 pigs), endoballoon rupture endoureterotomy.-Group II (5 pigs), Acucise® balloon endoureterotomy.Ureteral stents were placed for 3 weeks following endoureterotomy. Animals were followed up four weeks after ureteral stents retrieval. ResultsIn all cases, ureteral stricture was proved four weeks after model induction. In one case from each group, it was needed a second balloon dilatation to achieve complete endoureterotomy. Leading to ureteral restenosis, stent migration occurred in one animal from group I. Success was achieved in 80% of cases from group I, and 100% of cases from group II. ConclusionsOur results suggest that both endourological therapies are effective. Nevertheless, a higher efficiency was proved with Acucise® endoureterotomy. Our pathological evidences do not support Davis’s studies on ureteral healing following endoureterotomy.

Use of epidermal growth factor and collagen synthesis inhibition as adjuvant to healing of ureteroureteral anastomosis.

When treating a ureteral narrowing by endopyelotomy or endoureterotomy, the urologist hopes that after the narrowed area is cut, it will heal with a patent lumen. A ureteral stent is usually left in place to provide a framework for healing. In cases of failure, histologic examination shows a predominance of collagen. We evaluated the effects of epidermal growth factor (EGF) and a collagen synthesis inhibitor, halofuginone, as adjuncts to ureteral healing. Ten female pigs underwent ureteroureteral anastomosis bilaterally, with the left side being stented. They were then randomized to receive EGF (N = 4), halofunginone (N = 3), or saline (control; N = 3). On postoperative day 30, the ureters were examined grossly and histologically. The lumens of the ureters were significantly larger in the animals that received either EGF or funginone than in the control animals. The epithelium was significantly thicker in the animals that received halofunginone than in the controls or animals receiving EGF. The thickness of the smooth muscle and adventitia was similar in the three groups. Stenting improved the results. Both EGF and halofuginone show promise as adjuncts to endopyelotomy and endoureterotomy.

Use of ureteral stents after endopyelotomy.

Despite the widespread practice of endopyelotomy for the management of ureteropelvic junction obstruction, the optimal conditions for ureteral healing after endoincision remain largely untested. Current recommendations for the use of large-caliber graduated endopyelotomy stents and a 6-week duration of stenting are being challenged by recent reports of successful outcomes with the use of standard, small-caliber ureteral stents and early stent removal. Moreover, improvements in stent design have led to the development of endopyelotomy stents with improved biocompatibility, enhanced case of insertion, and fewer adverse effects.

Isolated ureteral injury caused by blunt trauma

Objectives Ureteral injury is rare after blunt trauma. Herein is presented this unusual scenario of ureteral trauma in addition to the pathophysiology of this injury. Methods A 12-year-old boy sustained a rupture of the right ureter 6 cm below the ureteropelvic junction afer a car accident. No other injuries or fractures were identified. Results Ureteral injury was immediately diagnosed and repaired primarily. Intravenous urography performed 8 weeks after surgery revealed normal ureteral healing without stricture formation. Conclusions To our knowledge, the isolated avulsion of the ureter in this location has not been reported previously, but must be considered in those patients with severe blunt trauma and hyperextension injuries.

Evaluation of optimal stent size after endourologic incision of ureteral strictures.

The stent size necessary to promote optimal ureteral healing after an endoureterotomy is not known. We compared healing of an endoureterotomy over a 7F indwelling ureteral stent with healing over a 14F endopyelotomy stent. A midureteral stricture was created in each of 25 anesthetized female minipigs using an electrified stone basket passed retrograde. Six weeks later, the stricture was incised with a 24F cutting balloon device. Twenty pigs were randomized to receive a 7F or a 14F stent; four control pigs received neither incisions nor stents. At 1 week, a radiograph was performed to confirm proper stent position, and the stents were removed. At 3 months, a retrograde ureterogram was performed, and the ureters were examined grossly and harvested for histologic studies. Two of the ten pigs in each study group developed a recurrent stricture. The use of a 14F stent provided no advantage over the use of a smaller, more easily positioned 7F stent.

Effect of Stent Duration on Ureteral Healing Following Endoureterotomy in an Animal Model

Ureteral strictures were created in 18 minipigs. Six weeks after stricture inducement, endourologic incision with a balloon cutting device was performed and a 7 F internal polyurethane stent was placed. After this step, 14 pigs remained in the study and were randomized into three different groups depending upon the time when the stent was removed: 1, 3 or 6 weeks. Twelve weeks after stricture incision, the pigs were killed, the status of the incised ureteral segment was evaluated histologically, and a healing score was determined. There were no statistically significant overall differences among the mean values of the overall healing score throughout the three different groups. However, when the one-week and the six-week groups (p < .05) were compared with respect to strictures requiring more than one incision due to stricture length greater than 2 centimeters, a more favorable outcome occurred in the 1 week group. Based on these findings it may be reasonable to remove ureteral stents as early as 1 week after endoureterotomy and endopyelotomy.

Healing and Muscular Restoration of the Ureteral Wall Following Balloon-Induced Rupture: An Experimental Animal Model with Light Microscopic and Ultrastructural Observations

Ureteral regrowth following balloon-induced rupture was studied using an animal model, with emphasis on the pattern and cellular events of self-reconstitution in the late phase of healing. At 4 weeks, the ureteral healing/remodeled region included a wedge-shaped muscular component which pointed toward a fibrous central zone, was continuous with the adjacent muscularis propria, and abutted on a thin-lining epithelium. Progressive enlargement, aggregation, and bundle formation of myogenic cells was observed along the centrifugal axis. At 7 weeks, there was near-total muscular continuity, a rudimentary lamina propria, and partial periluminal folding. Muscular restoration was unaffected by the use of a stent, but epithelial metaplastic changes were observed. The intermediate zone showed admixed fibroblasts, immature and mature myogenic cells, and myofibroblasts. Frequent plasmalemmal appositions and junctions were observed between different cell types, whereas myofibroblasts were not associated with cell-to-stroma attachments. Myofibroblasts might play more than a contractile role in this phase of ureteral healing, possibly having an induction role and/or representing a transient form in myogenic differentiation.

Perioperative Use of Indwelling Ureteral Catheter as an Adjunct to Ureteroscopic Stone Manipulation

Use of the ureteroscope to remove ureteral calculi under direct vision has improved the safety and efficacy of transurethral calculus management. As an adjunct to basketing with ureteroscopy, prior placement of a ureteral catheter for several days enables one to avoid the complications associated with rapid ureteral dilatation and immediate calculus extraction. It is also advantageous to leave an indwelling ureteral catheter to lessen postmanipulation colic and to facilitate ureteral healing following more traumatic extractions. In 25 consecutive patients, the original ureteral catheter used for soft dilatation was replaced for postmanipulation stenting immediately after calculus extraction. The only failure in the series was the result of an anesthetic reaction prior to ureteroscopy, and the stone passed spontaneously from the dilated ureter.

The Process of Ureteral Repair: A Recapitulation of the Splinting Question

No AccessJournal of Urology1 Feb 1958The Process of Ureteral Repair: A Recapitulation of the Splinting Question David M. Davis David M. DavisDavid M. Davis More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)66261-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1958 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByJABBOUR M, GOLDFISCHER E, ANDERSON A, SMITH A and KUSHNER L (2018) ENDOPYELOTOMY FAILURE IS ASSOCIATED WITH REDUCED TRANSFORMING GROWTH FACTOR-betaJournal of Urology, VOL. 160, NO. 6 Part 1, (1991-1994), Online publication date: 1-Dec-1998.Faerber G, Richardson T, Farah N and Ohl D (2018) Retrograde Treatment of Ureteropelvic Junction Obstruction Using the Ureteral Cutting Balloon CatheterJournal of Urology, VOL. 157, NO. 2, (454-458), Online publication date: 1-Feb-1997.Faerber G, Ritchey M and Bloom D (2018) Percutaneous Endopyelotomy in Infants and Young Children After Failed Open PyeloplastyJournal of Urology, VOL. 154, NO. 4, (1495-1497), Online publication date: 1-Oct-1995.Kerbl K, Chandhoke P, Figenshau R, Stone A and Clayman R (2018) Effect of Stent Duration on Ureteral Healing Following Endoureterotomy in an Animal ModelJournal of Urology, VOL. 150, NO. 4, (1302-1305), Online publication date: 1-Oct-1993.Selmy G, Hassouna M, Bégin L, Khalaf I and Elhilali M (2018) Long-Term Effects of Ureteric Stent after Ureteric DilationJournal of Urology, VOL. 150, NO. 6, (1984-1989), Online publication date: 1-Dec-1993.Schmeller N, Leitl F and Arnholdt H (2018) Histology of Ureter after Unsuccessful Endoscopic Intubated IncisionJournal of Urology, VOL. 147, NO. 2, (450-452), Online publication date: 1-Feb-1992.Clayman R, Basler J, Kavoussi L and Picus D (2018) Ureteronephroscopic EndopyelotomyJournal of Urology, VOL. 144, NO. 2 Part 1, (246-251), Online publication date: 1-Aug-1990.Smith A (2018) Editorial CommentsJournal of Urology, VOL. 144, NO. 2 Part 1, (251-251), Online publication date: 1-Aug-1990.Biester R and Gillenwater J (2018) Complications Following UreteroscopyJournal of Urology, VOL. 136, NO. 2, (380-382), Online publication date: 1-Aug-1986.Diamond D and Marshall F (2018) The Diagnosis and Management of Spontaneous Rupture of the UreterJournal of Urology, VOL. 128, NO. 4, (808-810), Online publication date: 1-Oct-1982.Amar A, Das S and Bulusu N (2018) Ureteral Strictures Following UreterolithotomyJournal of Urology, VOL. 125, NO. 3, (416-419), Online publication date: 1-Mar-1981.Dorr R, Ratliff R and Hyndman C (2018) Technique of Ureteral Repair Using an Indwelling Ureteral StentJournal of Urology, VOL. 111, NO. 4, (481-482), Online publication date: 1-Apr-1974.Lucey D, Smith M and Koontz W (2018) Modern Trends in the Management of Urologic TraumaJournal of Urology, VOL. 107, NO. 4, (641-646), Online publication date: 1-Apr-1972.Ross G, Thompson I, Bynum W and Thompson E (2018) The Role of Smooth Muscle Regeneration in Urinary Tract RepairJournal of Urology, VOL. 95, NO. 4, (541-546), Online publication date: 1-Apr-1966.Kozak J, Deniz E and McDonald J (2018) Observations on Reparative Processes of Lower Third of Ureter Following Total Segmental ResectionJournal of Urology, VOL. 91, NO. 5, (509-514), Online publication date: 1-May-1964.Kočvara S and Žák F (2018) Ureteral Substitution with Dacron and Teflon ProsthesesJournal of Urology, VOL. 88, NO. 3, (365-376), Online publication date: 1-Sep-1962.Torbey K and Leadbetter W (2018) The Use of the Seromuscular Layer of an Ileal Loop for Ureteral ReplacementJournal of Urology, VOL. 88, NO. 6, (746-757), Online publication date: 1-Dec-1962.Smart W (2018) An Evaluation of Intubation Ureterotomy With a Description of Surgical TechniqueJournal of Urology, VOL. 85, NO. 4, (512-524), Online publication date: 1-Apr-1961.Wharton L, Creecy A and Beazlie F (2018) Regeneration of the Female Urethra Following Severe Injury and Observations on the Localization of Urinary ControlJournal of Urology, VOL. 82, NO. 1, (105-108), Online publication date: 1-Jul-1959.Gibson T (2018) Hydronephrosis: Its Treatment in the Solitary KidneyJournal of Urology, VOL. 81, NO. 3, (374-378), Online publication date: 1-Mar-1959.Casey W (2018) Unintubated Pyeloplastic Operations for Hydronephrosis: Results of 21 CasesJournal of Urology, VOL. 81, NO. 5, (612-617), Online publication date: 1-May-1959.Malcolm D and Dorsey J (2018) Reoperative Correction of Previous Pelvioureteral Plastic SurgeryJournal of Urology, VOL. 80, NO. 6, (436-442), Online publication date: 1-Dec-1958. Volume 79Issue 2February 1958Page: 215-223 Advertisement Copyright & Permissions© 1958 by The American Urological Association Education and Research, Inc.MetricsAuthor Information David M. Davis More articles by this author Expand All Advertisement Loading ...

Intubated Ureterotomy: Experimental Work and Clinical Results

Intubated Ureterotomy: Experimental Work and Clinical Results