Summary
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.
Keywords
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 accessOne-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:
Subscribe to Journal of Pediatric UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ureterorenoscopy: avoiding and managing the complications.Urol Int. 2011; 87: 251-259https://doi.org/10.1159/000329286
- Buccal mucosal grafts in the treatment of ureteric lesions.BJU Int. 1999; 83: 751-754https://doi.org/10.1046/j.1464-410x.1999.00019.x
- Robotic buccal mucosal graft ureteroplasty for complex ureteral stricture.Urology. 2017 Dec; 110 (Epub 2017 Jul 6): 257-258https://doi.org/10.1016/j.urology.2017.06.037
- RUG technique: replacement of the ureter with gonadal vein. A cadaveric study.Minerva Urol Nefrol. 2019; 71: 85-91https://doi.org/10.23736/S0393-2249.18.03261-7
Article info
Publication history
Published online: September 28, 2020
Accepted:
September 18,
2020
Received in revised form:
August 26,
2020
Received:
July 8,
2020
Identification
Copyright
© 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
