Endoscopic ureteroureterostomy for obliterated ureteral segments.

Abstract

Advances in endourological techniques and instrument design have made the endoscopic treatment of complete ureteral obstruction a reasonable alternative to open surgery. We report our experience with endourological management of 10 cases of obliterated ureteral segments. Endoscopic ureteroureterostomy was performed in 8 patients with complete ureteral obstruction and it was not attempted in 2 because of the length or orientation of the obliterated segment. Access, incision and stenting of the obliterated segment were technically successful in 8 patients. Two patients had patent ureters but required a stent, including 1 who underwent nephrectomy due to problems with stent management. Endoscopic treatment achieved long-term patency in 7 of the 8 cases and it was completely successful in 6 (75%) at a median followup of 87 months (range 4 to 126). Endoscopic ureteroureterostomy is a safe and effective technique for the management of obliterated ureteral segments less than 2 cm. long with adequate alignment.