WCE 2017: Single Surgeon Experience with Revision of Ureteroenteric Anastomosis for Benign Strictures after Urinary Diversion

Vancouver, Canada (UroToday.com) Eric Schommer and colleagues present a retrospective study of a single surgeon’s experience with 159 patients who underwent a urinary diversion through an open approach. Twenty patients (12.6%) developed ureteroenteric strictures (UES) of both benign and malignant etiologies. This is consistent with previously reported stricture rates ranging from 10% to 12.7%. Of the patients who developed a UES, thirteen patients (65%) eventually underwent an open revision of the ureteroenteric anastomosis. Twelve of these thirteen patients (92.3%) showed an improvement in hydronephrosis. This is again consistent with the high success rates reported in the literature for open management of UES.

The effort of the authors to address the difficult topic of managing ureteroenteric anastomotic strictures deserves applause. However, several points need clarification. First, the authors do not specify whether patients underwent primary versus secondary open management of UES. Second, the authors do not indicate whether intraoperative stenting of the ureteroenteric anastomosis was performed. Urine leak is a risk factor for stricture formation and at least one patient in this study developed an anastomotic leak.

Of course, the retrospective nature of this study limits its ability to provide definitive guidelines for the prospective management of UES. However, the data presented here reinforce previous findings in the literature.

Authors: Eric Schommer, Andrew Davidiuk, Laura Gundian, Kaitlynn Custer, and Paul Young – Mayo Clinic, Jacksonville, FL, USA

Written by: Michael Owyong (@ohyoungmike), LIFT Fellow, Department of Urology, UC Irvine Medical Center at the 35^th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.

Login