Treatment of long ureteric strictures with buccal mucosal grafts

Study Type – Therapy (case series)
Level of Evidence 4

OBJECTIVE

To describe the reconstruction of long ureteric strictures using buccal mucosal patch grafts and to report the intermediate‐term functional outcome.

PATIENTS AND METHODS

Between November 2000 and October 2006 reconstruction of seven long ureteric strictures using buccal mucosal patch grafts and omental wrapping was performed in five women (one with bilateral strictures) and one man. The surgical steps of stricture reconstruction and wrapping with omentum are described in detail. Stricture recurrence was defined as persistent impaired ureteric drainage as displayed by imaging techniques or the necessity to prolong JJ stenting. Patency rates and stricture recurrence‐free survival rates are provided.

RESULTS

With a median follow up of 18 months five of the seven strictures were recurrence‐free. Graft take was good in all patients. In one asymptomatic patient, there was impaired ureteric drainage on the reconstructed side, and in one patient with reconstruction of both ureters prolonged JJ stenting of one side was necessary. In both patients, the impaired drainage was caused by persistent stricture below the reconstructed ureteric segments.

CONCLUSIONS

At intermediate‐term follow‐up in a small group of patients with long ureteric strictures, treatment with buccal mucosal patch grafts and omental wrapping showed good functional outcome.