Acucise incision of ureteroenteric strictures after urinary diversion

Abstract

Four ureteroenteric strictures in three men were incised using the Acucise catheter. All patients had undergone urinary diversion after radical cystectomy. One patient had a solitary kidney, and one patient had bilateral ureteroenteric strictures. Two patients were morbidly obese. One stricture involved the right ureter, and the left ureteral anastomosis was strictured in all three cases. After careful radiographic and endoscopic assessment of local periureteral anatomy, Acucise incision was performed successfully for all four strictures without complications. All incised ureteroenteric anastomoses have remained patent through postoperative follow-ups of 11, 27, and 28 months, as judged by retrograde loopograms and diuretic renograms. Acucise incision of ureteroenteric stricture after urinary diversion provides an efficient and effective endourologic management option in these difficult cases. Emphasizing the need for careful preincision anatomic evaluation, this technologic approach can be employed even in the management of left ureteroenteric strictures.