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Early experience in reconstruction of long ureteral strictures with allogenic amniotic membrane
Author(s) -
Koziak Andrzej,
Salagierski Maciej,
Marcheluk Adam,
Szcześniewski Ryszard,
Sosnowski Marek
Publication year - 2007
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2007.01781.x
Subject(s) - medicine , ureter , hydronephrosis , pyelogram , stenosis , surgery , urinary system , etiology , urology , radiology , anatomy
Objective: To present our experience with the application of human amniotic membrane for the reconstruction of extensive ureteral wall defects. Methods: Between 2003 and 2006, 11 patients underwent reconstructive surgery of the ureter. A human amniotic membrane allograft was used to supplement ureteral wall defects. Indications for the procedure included ureteral strictures of a 5.5 cm average (range, 3–8 cm) localized in different parts of the ureter: upper (5), middle (5) and lower (3). The etiology of ureteral loss was: postinflammatory after a complicated stone disease (5), iatrogenic (4) and idiopathic (2). Diagnosis of ureteral stricture was based on antegrade pyelography and excretory urography. Two patients had synchronous treatment for upper and middle ureteral stenosis. Treatment efficacy was assessed by excretory urography and ultrasound. Results: The mean hospitalization time was 11.9 days, mean operation time 128 min and with an average follow up of 25.2 months. Complications included: stricture recurrence (1) and symptomatic urinary tract infections (2). Excretory urography showed lack of obstruction and normal width of ureters. In one patient, residual hydronephrosis was present on ultrasound. Conclusions: The described method seems to be a promising tool in the reconstruction of extensive ureteral strictures.