ABSTRACT
【Objective】 To investigate the common etiology, characteristics and treatment of iatrogenic ureteral stricture. 【Methods】 The clinical data of 226 patients with ureteral stricture repaired during May 2019 and Mar. 2022 were retrospectively analyzed, including 68 cases of iatrogenic ureteral stricture. According to the etiology, the patients were divided into urinary group and non-urinary group. 【Results】 There were 42 females and 26 males, aged 25 to 67 (average 49.0±10.4) years. Upper ureteral stricture was detected in 24 (35.3%) cases, who received oral mucosal repair of the ureter. Middle ureteral stricture was detected in 12 (17.6%) cases, who underwent ileal ureterography. Lower ureteral stricture was observed in 24 (35.3%) cases, who were treated with vesical wall flap ureteroplasty. Full-length stricture was observed in 8 (11.8%) cases,who were treated with ileal ureterography. There were significant differences in age, gender, stenosis side, stenosis location and length, surgical methods and types between patients in the urinary group and non-urinary group (P<0.05). During the follow-up of 8 to 20 (average 12.3±5.6) months, the symptoms and renal function of all patients improved, and no recurrence occurred. 【Conclusion】 Invasive endourological surgery is the most common cause of iatrogenic ureteral stenosis. Different treatment strategies should be adopted according to patients’ condition, time of diagnosis and location and length of ureteral injury.
ABSTRACT
Objective To assess the feasibility of heterogeneous acellular dermal matrix(ADM)seeded with adipose derived stem cells(ADSC)for urethroplasty in a rabbit model.Methods ADSC were isolated from a rabbit and expanded in vitro,then identified by flow cytometry.We seeded ADSC onto the ADM and made it into tissue-engineered urethra.12 male rabbits were removed 1 cm urethra and divided into experiment group and control group.There were 6 rabbits in each group.Reconstructed urethra with tissueengineered urethra was used in experiment group,while unseeded ADM were used in control group.Urethrography was performed at 6 months after surgery.The animals were scarified at 3 and 6 months after surgery and the repaired urethra were harvested.H&E staining and immunohistochemical staining were performed with cytokeratin AE1/AE3 and smooth muscle desmin makers.Results The morphology of isolated ADSC was with long spindle cross-links,and had multicentral growth.Flow cytometry showed that the ADSC expressed CD166,CD105,CD90 and CD44,but not expressed CD45 and CD13.The cells could growth well on the ADM and showed good biocompatibility with it.All animals could void normally,urethrography showed there was no significant stenosis.3 months after surgery,the experiment group appeared regenerated smooth muscle but not in the control group,both groups did not regenerate urothelium.At 6 months urothelium and smooth muscle cells could be observed in the experiment group,but only the smooth muscle was evident in the control group.Conclusions By applying tissue engineering methods,we can seed the ADSC onto the heterogeneous ADM and make it into tissue-engineered urethra,which can help improve the reconstructive effect of urethra.