Clinical outcomes and health-related quality of life assessment following minimally invasive reconstructive surgery for benign ureteral strictures.

Abstract

Background: To evaluate the clinical efficacy of minimally invasive ureteral reconstruction for benign strictures and analyze its impact on health-related quality of life (HRQoL) and psychological status.

Methods: This retrospective study included 29 patients undergoing robotic/laparoscopic ureteral reconstruction at our institution. Surgical outcomes were assessed through imaging, laboratory parameters, and patient-reported outcomes assessed via the validated SF-36 quality-of-life instrument and Hospital Anxiety and Depression Scale (HADS) psychological distress screening tool.

Results: With a median follow-up of 12 months, the surgical success rate was 96.6%. The perioperative complication rate was 6.90% (2 cases of transient high fever), with no severe adverse events observed. Preoperative SF-36 scores in physical functioning (PF) and bodily pain (BP) domains were significantly lower than those of the general population (p < 0.001). Postoperatively, except for vitality(VT) and mental health (MH) domains which surpassed population norms, scores in other dimensions showed no significant differences compared to the general population (p > 0.05). Notably, all SF-36 domains demonstrated significant improvement from baseline (p < 0.05). Additionally, both anxiety and depression scores assessed by HADS decreased markedly after surgery (p < 0.05).

Conclusion: Minimally invasive ureteral repair and reconstruction effectively relieves obstruction, improves renal function, and significantly enhances health-related quality of life and psychological well-being, representing a safe therapeutic option for benign ureteral strictures. Surgical intervention reduces the need for long-term stent or nephrostomy placement, thereby alleviating physical and psychological burdens. Further studies with expanded cohorts and extended follow-up durations are warranted to validate long-term outcomes.