PURPOSE: We defined the role of the Boari bladder flap procedure with or without downward nephropexy for proximal vs distal ureteral strictures. MATERIALS AND METHODS: We retrospectively reviewed the records of all patients who underwent open ureteral reconstruction for refractory ureteral strictures, as done by a single surgeon between 2007 and 2010. Patients were grouped by stricture site into group 1--proximal third of the ureter and group 2--distal two-thirds. Operative techniques and outcomes were reviewed. RESULTS: During the 30-month study period a total of 29 ureteral reconstruction procedures were performed on 27 patients. A Boari bladder flap was used in 10 of the 12 patients (83%) in group 1 and 10 of the 17 (59%) in group 2. Concomitant downward nephropexy was done more commonly in group 1 (58% vs 12%, p = 0.014). At a mean followup of 11.4 months there was no difference in the overall failure rate between groups 1 and 2 (17% vs 12%). Complications developed more frequently in group 1 (75% vs 35%, p = 0.060), hospital stay was longer (mean 8.0 vs 4.4 days, p = 0.017) and mean estimated blood loss was greater (447 vs 224 ml, p = 0.008). CONCLUSIONS: The Boari bladder flap procedure is a reliable technique to reconstruct ureteral strictures regardless of site. Renal mobilization with downward nephropexy is a useful adjunctive maneuver for proximal strictures.
PURPOSE: We defined the role of the Boari bladder flap procedure with or without downward nephropexy for proximal vs distal ureteral strictures. MATERIALS AND METHODS: We retrospectively reviewed the records of all patients who underwent open ureteral reconstruction for refractory ureteral strictures, as done by a single surgeon between 2007 and 2010. Patients were grouped by stricture site into group 1--proximal third of the ureter and group 2--distal two-thirds. Operative techniques and outcomes were reviewed. RESULTS: During the 30-month study period a total of 29 ureteral reconstruction procedures were performed on 27 patients. A Boari bladder flap was used in 10 of the 12 patients (83%) in group 1 and 10 of the 17 (59%) in group 2. Concomitant downward nephropexy was done more commonly in group 1 (58% vs 12%, p = 0.014). At a mean followup of 11.4 months there was no difference in the overall failure rate between groups 1 and 2 (17% vs 12%). Complications developed more frequently in group 1 (75% vs 35%, p = 0.060), hospital stay was longer (mean 8.0 vs 4.4 days, p = 0.017) and mean estimated blood loss was greater (447 vs 224 ml, p = 0.008). CONCLUSIONS: The Boari bladder flap procedure is a reliable technique to reconstruct ureteral strictures regardless of site. Renal mobilization with downward nephropexy is a useful adjunctive maneuver for proximal strictures.
Authors: Jan P Radtke; Nina Korzeniewski; Johannes Huber; Celine D Alt; Sascha Pahernik; Boris A Hadaschik; Markus Hohenfellner; Dogu Teber Journal: Langenbecks Arch Surg Date: 2017-01-16 Impact factor: 3.445
Authors: Shengwei Xiong; Jie Wang; Weijie Zhu; Kunlin Yang; Guangpu Ding; Xuesong Li; Daniel D Eun Journal: Biomed Res Int Date: 2020-07-27 Impact factor: 3.411
Authors: Lukas John Hefermehl; Stefan Tritschler; Alexander Kretschmer; Vincent Beck; Christian G Stief; Boris Schlenker; Frank Strittmatter Journal: Investig Clin Urol Date: 2020-03-09