Vesical Mucosal Graft for the Treatment of Ureteral Strictures with a Total Robot-assisted Approach

Abstract

Background and objective: Ureteral strictures can be iatrogenic and caused by stones, radiation, autoimmune diseases, and trauma. Laparoscopic or robot-assisted ureteroplasty (RAUP) with grafts for short ureteral strictures has been described in several studies. Our objective was to show the efficacy and safety of vesical mucosa grafts (VMGs) for treatment of ureteral strictures via RAUP.

Methods: We conducted a single-center retrospective study to evaluate the role of VMGs in the treatment of iatrogenic ureteral strictures in a cohort of 14 patients who underwent RAUP. Descriptive analyses of clinical and demographic data, including stricture length, operative time, hospitalization, complications, and follow-up, were performed. All patients underwent RAUP using VMGs with a da Vinci Xi robotic system.

Key findings and limitations: Mean stricture length in the cohort was 4.07 cm (range 3-6). The mean operative time was 141 min (range 110-180) and the mean hospital stay was 6.3 d (range 5-10). No Clavien-Dindo grade >2 complications were observed. No stenosis recurrence had occurred at 21.3 mo. Limitations include the small sample size and short follow-up.

Conclusions and clinical implications: Our study shows that RAUP with VMGs may represent a valid approach for the treatment of ureteral strictures of up to 6 cm in length.

Keywords: Robot-assisted ureteroplasty; Ureteral stricture; Vesical mucosa.