Video Bank| Volume 16, ISSUE 5, P729-730, October 2020

Laparoscopic ureteroplasty with gonadal vein graft for long ureteral stenosis: A step by step video

Published:September 28, 2020DOI:


      Strictures of the ureter may occur from iatrogenic injury or impacted kidney stones. Complications from ureteroscopy may result in ureteral stricture in 0,5–2% of patients. New techniques are being described in order to minimize the morbidity associated with classic approaches. This is a step-by-step video of this novel technique: a successful laparoscopic ureteroplasty with gonadal vein graft for a iatrogenic long ureteral stenosis.
      A 16 year old female patient, with multiple previous ureteroscopies for ureteral stones, presented with severe left lumbar pain. An abdominal CT and a pyelography were performed showing a 3 cm left mid-proximal ureteral stricture with proximal hydronephrosis.
      The stenotic area was identified and an anterior left ureteral incision was made. Gonadal vein was removed and prepared, being sutured in the anterior surface of the ureter. Patient was discharged in the second post operative (PO). JJ stent was removed after 1 month. A 3 month PO pyelography was performed, showing no fistula and resolution of the stricture. Twelve months after surgery, the patient was painless with symptom resolution.
      The use of gonadal vein as a graft for ureteral strictures is a new possible approach, although more cases are necessary to evaluate its results.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • D'Addessi A.
        • Bassi P.
        Ureterorenoscopy: avoiding and managing the complications.
        Urol Int. 2011; 87: 251-259
        • Naude J.H.
        Buccal mucosal grafts in the treatment of ureteric lesions.
        BJU Int. 1999; 83: 751-754
        • Arora S.
        • Campbell L.
        • Tourojman M.
        • Pucheril D.
        • Jones L.R.
        • Rogers C.
        Robotic buccal mucosal graft ureteroplasty for complex ureteral stricture.
        Urology. 2017 Dec; 110 (Epub 2017 Jul 6): 257-258
        • Dal Moro F.
        • Macchi V.
        • Porzionato A.
        • Mandato F.G.
        • de Caro R.
        RUG technique: replacement of the ureter with gonadal vein. A cadaveric study.
        Minerva Urol Nefrol. 2019; 71: 85-91