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Reconstructive surgery of long ureter strictures using xenogenic collagen grafts
Article published in Urologia Polska 2004/57/1.

authors

Andrzej Koziak, Adam Marcheluk, Tadeusz Dmowski, Ryszard Szcześniewski, Piotr Kania, Adam Dorobek
Oddział Urologii im. Prof. Tadeusza Krzeskiego Wojewódzkiego Szpitala Specjalistycznego w Siedlcach
Ordynator oddziału: dr n. med. Andrzej Koziak

keywords

ureter, ureter reconstruction, ureter stricture, collagen, dura mater, amnion, xenogenic graft

summary

objective
Assessment of technical aspects of surgical procedure and biomaterials (pure collagen membrane, human dura mater, human amnion) used as a scaffold in reconstruction of the wall of strictured ureters.
materials and methods
Between 1980 and 2002 there were 20 patients (14 women and 6 men) in whom long ureter stricture in its different part - upper (5), middle (8), lower (7) was diagnosed and ureter reconstructive surgery was performed. Different collagen contained biomaterials in the ureter wall loss reconstruction - pure collagen membrane (10 patients), human dura mater (8), human amnion (2) were used. Before reconstructive surgery, urographic or pyelographic x-rays revealed hydronephrosis on the side of strictured ureter and no urine passage or trace of it in the narrowed part. Patients with stricture over 4 cm long were qualified to the surgery. Ureter was prepared from adjacent tissues. Then a longitudinal incision was performed, taking care not to break the continuity of the ureter. On a such prepared place an earlier set up collagen graft was put and loosely sewed. Then urine efflux was secured by a "pig tail" catheter (DJ stent) for 2-3 weeks inside operated ureter.
results
Hospitalization time after surgery amounted to 8-10 days. Follow-up urographies (early and late) showed withdrawal of hydonephrosis and ureters of regular width. Urinary tract infection after surgery was not observed.
conclusions
Easy surgical procedure, no complications after surgery, no stricture recurrence, outstanding early and late results prove efficacy and quality of proposed treatment.

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correspondence

Andrzej Koziak
Wojewódzki Stpltal Specjalistyczny
Oddział Urologii im. Prof. Tadeusza Krzeskiego
ul. Poniatowskiego 26
O8-11O Siedlce
te/.: (0-25) 640 15 15. fax: 640 32 98