Laparoscopic ureteroneocystostomy for management of lower ureteric strictures

ABSTRACT

We assessed the results of laparoscopic transperitoneal ureteroneocystostomy with or without a psoas hitch for management of lower ureteral strictures. Between October 2005 and August 2008, 16 patients with lower ureteric strictures underwent laparoscopl uretroeocystostomy with or without a psoas hitch. Etiology of strictures was gynecological surgery in 11, surgery for stone disease in 3, ureterovaginal fistula in 1 and primary obstructive megaureter in 1. Transperitoneal 3- or 4-port laparoscopic ureteroneocystostomy was performed with or without psoas hitch. 1. All operations were successfully completed without any need for conversion to open. Mean operative time was171.56 min [range 130 to 260 min], mean blood loss was 93.44 cc [range 30 to 200 cc] and total hospital stay was 3.73 days [range 3 to 6 days]. Mean time to resume oral intake was 12.5 h [range 8 to 22 h]. Mean follow-up period was 21.83 months [range 6-39 months]. Postoperative follow-up investigations revealed successful outcome in all 16 patients, success being defined as relief of symptoms and radiological improvement, irrespective of the refluxing status. Non-refluxing status was achieved in 15 out of 16 patients as determined by micturition cystography. Laparoscopic ureteroneocystostomy is a safe and effective procedure, with inherent advantages of laparoscopic surgery