Buccal ureteroplasty for recurrent extended strictures and obliterations of distal ureter

Volkov AA1, Budnik NV1, Zuban ON2, Abdulaev MA1, Plotkin DV2, Reshetnikov MN2
About authors

1 Hospital for War Veterans, Rostov-on-Don, Russia

2 Moscow Research and Clinical Center for TB Control, Moscow, Russia

Correspondence should be addressed: Andrey A. Volkov
pereulok Zaprudny, 17, Rostov-on-Don, 344020; ur.kb@a37voklov

About paper

Author contribution: Volkov AA, Budnik NV — study conceptualization and design development, shared responsibility, text preparation; Abdulaev MA — material collection; Volkov AA, Reshetnikov MN, Plotkin DV — statistical data processing; Volkov AA, Zuban ON — obtained data analysis; Volkov AA, Zuban ON, Reshetnikov MN — editing.

Compliance with ethical standards: the study was approved by the ethics committee of the Hospital for War Veterans (Minutes #1 of February 6, 2018). All participants submitted the signed informed consent forms confirming their consent to participate in the study.

Received: 2020-10-25 Accepted: 2020-12-05 Published online: 2020-12-17

At the current stage of development of urology, selection of the surgical method for cases of severe obstructive diseases of the upper urinary system remains a challenge. This study aimed to explore the results of application of a buccal graft (BG) to remedy extended recurrent strictures and obliterations of the distal ureter. Seven patients with the mentioned diseases had undergone surgery: for six of them, the method of choice was complete BG ureteroplasty, one had onlay ureteroplasty. One intervention was laparoscopic, the remaining surgeries were open. The length of the replaced ureteral defect was 5–8 cm. In five cases, the flap was additionally vascularized with the iliac muscle, in one we used omentum tissue, in another — both the iliac muscle and the omentum. There were no fatalities registered, nor severe complications as per the Clavien–Dindo classification. The patients were followed-up for 4–18 months; as of today, no recurrence cases were identified. Control examinations showed complete patency of the neoureter and good vascularization of the BG. Thus, this method can be an option in cases disallowing distal ureter restoration with tissues of the patient's own urinary tract or segments of the gastrointestinal tract.

Keywords: buccal mucosa graft, ureteral obstruction, ureteral obliteration, ureteral stricture, distal ureter