TECHNICAL FEATURES OF INTESTINAL URETEROPLASTY. PART 2: RIGHT-SIDED ILEOURETEROPLASTY

Aim: To present the results of intestinal ureteroplasty and technical features of right-sided ileoureteroplasty. Material and methods: From 2001 to 2015, 78 patients underwent isolated reconstruction of the ureter using a segment of the ileum, of whom 57 (73%) and 21 (27%) patients had unilateral and bilateral operation, respectively. In total, isolated segments of the ileum were used to substitute 101 ureters including 45 (44.6%) right ureters. Results: The follow-up period ranged from 3 months to 14 years (mean 8.3 ± 0.8 years). Early postoperative complications occurred in 8 (10.2%) patients and 5 (6.4%) of them required reoperation. Long-term postoperative complications occurred in 7 (8.9%) patients and 4 required surgical treatment. All patients had good results of conservative treatment and reoperations. There were no deaths. All patients achieved restoration of urodynamics and normalization of kidney function. Conclusion: Right-sided, especially total, ileoureteroplasty is the most technically challenging among other possible options to substitute the ureter with a small bowel segment. To avoid mesenteric torsion when performing isoperistaltic ureteroplasty, the graft should be placed above and in front of the intestinal anastomosis.

ureter, stricture, intestinal substitution