Purpose: To evaluate the safety and efficacy of retrograde placement of single-J stent guided by flexible cystoscope for management of ureteroenteric anastomotic stricture in patients after radical cystectomy and Bricker urinary diversion.
Materials and Methods: Between January 2008 and June 2012, 11 patients with ureteroenteric anastomotic stricture after open radical cystectomy and Bricker urinary diversion were enrolled in this study. All patients were treated with retrograde placement of single-J stent guided by flexible cystoscope. A 7 Fr single J stent was placed for 6 weeks.
Results: Of the 11 patients, 7 strictures occurred on left side, 2 on the right side and 2 on the both sides. The retrograde procedure was successfully performed in 10 cases, and the remaining one was successful on right side but failed on left side. Upper urinary tract infection was well controlled in all the 3 patients with fever. After a follow-up for 12-66 months, 8 patients had long-term symptom relief, one patient had open surgery to remove stricture and re-implant the ureter, and one patient died because of tumor recurrence. The only failed case had a left side percutaneous nephrostomy, but he was lost to follow-up.
Conclusions: Retrograde placement of single J ureteral stent guided by flexible cystoscope is safe and effective for ureteroenteric anastomotic stricture in patients with Bricker urinary diversion, and it brings fewer complications. The procedure is minimally invasive and could avoid immediate surgery for most patients.
Written by:
Zhang Z, Zhang C, Wu C, Yang B, Wang H, Hou J, Xu C, Sun Y. Are you the author?
Changhai Hospital, Urology, 168 Changhai Road, Yangpu District, Shanghai, China, 200433.
Reference: J Endourol. 2014 Jul 1. Epub ahead of print.
doi: 10.1089/end.2014.0196
PubMed Abstract
PMID: 24984054
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