Login to Access Video or Poster Abstract: MP24-05
Sources of Funding: none

Introduction

To assess the long-term outcomes and complications of Ileal Ureter Replacement (IUR) compared to the use of Memokath 051 for ureteral reconstruction.

Methods

In the last 10 years, two groups of patients with ureteral strictures (benign or malignant) have been followed up retrospectively. The first group consists of 17 patients, mean age of 59 years, presented with ureteral obstruction and treated with a thermoexpandable stent Memokath as a minimally-invasive procedure. Whereas the second group of 27 patients, mean age of 55 years received an IUR as alternative treatment method. Patients were followed for a mean period of 42 months. Assessment included examination of serum creatinine, renal ultrasound, retrograde pyelography and isotopic renography.

Results

In the first group (17 pat., 27 renal units): upper tract decompression was succeed in 6 renal units only (35%), in which 3 patients had initially no obstruction and the other 3 developed a temporary obstruction. 11 Patients developed a permanent obstruction (65%), 8 of those patients received another minimally-invasive treatment like percutaneous nephrostomy, DJ stent or reinsertion of Memokath stent. 3 patients underwent open surgery. 7 patients developed urinary tract infections (41%). Obstruction with deterioration of renal function secondary to dislocation of the stent developed in 5 patients (8 renal units - 29%). Early total obstruction due to insufficient dilatation effect of the stent took place in 1 patient. Other complications included: gross hematuria, irritative voiding, urinary retention as well as ureteroenteric fistula in 1 patient (3.7% of the renal units). _x000D_ In the second group, upper tract decompression was achieved in 24 (88.8%) patients; a secondary nephrectomy was performed in 2 patients. 1 patient underwent resection of the ileal interponate because of leakage of the pyelo-ureteral and uretero-vesical anastomosis due to malvascularization (advanced PAD). Secondary complications occurred in 4 (14.8%) patients: n = 2 urinary tract infections, n = 1 pelvic vein thrombosis, n = 1 wound infection. Renal function remained stable in all patients, and metabolic acidosis was not observed.

Conclusions

The IUR is an effective reconstructive measure of the upper urinary tract with a low complication rate and good long-term functional results. The IUR should be preferred to the Memokath, which is an alternative niche solution.

Funding

none