Managing Mid and Lower Ureteral Benign Strictures: The Laparoscopic Way

The aim of this study is to assess etiopathogenesis of ureteral mid/lower benign strictures and outcomes of various methods of laparoscopic reconstruction and repair. We retrospectively reviewed the data of patients who underwent laparoscopic repair for mid and lower ureteral benign strictures at our department from January 2013 to February 2016. The demographic, operative, complication, and outcome data were analyzed. Twenty-two patients were treated by various methods of laparoscopic reconstruction in the department of urology for benign ureteral strictures. Ureteroneocystostomy was done by psoas hitch in 15 and Boari flap in 2. Ureteral tapering, followed by ureteral reimplantation, was done in 2 and ureteroureterostomy in 3 cases. The most common predisposing factor that leads to ureteral stricture was prior pelvic gynecological surgery. Other causes included endometriosis, tuberculosis, impacted ureteral calculus, and ureteroscopic removal of calculus. Seventeen patients had lower, 3 had mid, and 2 had mid/lower ureteral strictures. Ureteral patency was successfully reestablished in all 22 patients without significant complications during a mean follow-up of 25 months (range 12-48 months). Laparoscopic treatment of benign ureteral strictures imparted excellent outcomes without major complications with the advantage of the minimally invasive technique.