RESUMO
Our purpose in this study is to evaluate the efficacy and safety of ureteroscopy in-patients with a re-implanted bilharzial ureter. The study included twenty-one patients with prior ureterovesical reimplantation because of bilharzial ureteral strictures. Seventeen patients had distal ureteral stones [2 multiple]. Four patients had retained foreign body in a re-implanted ureter; proximally migrated double-J stents in 3 and postoperative retained plastic catheter in one patient. Ureteroscopic manipulation was done for all patients using a small diameter ureteroscope 7.5 F. Preliminary cystoscopy revealed different locations for neo-ureteral orifices. Posteromedial in 13 patients, posterolateral in 2 patients and anterolateral in 6 patients. Stones were extracted in 15 patients [13 with single distal ureteral stones and 2 with multiple stones]. Stones were retrieved more easily in cases with posteromedially located orifices. Failure to negotiate the guide wire up the ureters was encountered in the 2 cases with posterolateral location of the orifices with termination of the procedure. Extraction of the proximally migrated stents and foreign body was successful in all the patients using a 3 pronged grasper. The location of the ureteral orifice influenced the success of the procedure. Reimplantation in the posteromedial location was the easiest to manipulate. Ureteroscopy has its role in patients with re-implanted bilharzial ureter. It can save the patient from a recurrent surgery with minimal or no complications. The site of the neo-ureteral orifices influence the success of the procedure