[Endoscopic treatment of obliteration of the ureteral orifice after transurethral resection of bladder tumor. Rendez-vous technique].

Abstract

Introduction: Transurethral resection is the main method for diagnosing and staging bladder cancer, which allows to determine treatment tactics. Tumors located in the area of the ureteric orifice is an important clinical problem.

Aim: To describe our experience in the treatment of ureteral obliterations after transurethral resection of the bladder tumors.

Materials and methods: From 2021 to 2023 in the CDC "Zdorovie" in Rostov-on-Don, a total of 6 patients underwent endoscopic recanalization of the obliteration of the ureteral orifice after transurethral resection of bladder cancer.

Results: The average follow-up period for patients was 6 months. The average duration of the operation was 42 minutes, bladder catheterization 2 days. One of the main criteria for the efficiency of treatment was the absence of upper urinary tract obstruction 3 months after stent removal. In 3 patients, ureteral stents were removed. In two cases, the absence of stricture recurrence was confirmed; in one patient with a stricture of 1 cm in length, a relapse was detected.

Discussion: In this article, we describe a technique for endoscopic treatment of iatrogenic obliteration of the ureteral orifice and intramural part of the ureter, in which a combination of antegrade and retrograde access (Rendez-vous) or "cut-to-the-light" technique allows to restore ureteral patency.

Conclusions: The endoscopic approach in patients with obliteration of the ureteral orifice after transurethral resection of a bladder tumor is an alternative to open or laparoscopic ureteral reimplantation and provides high efficiency with a low percentage of complications.