Surgical Treatment of Ureteral Stenosis in Urinary Diversions: Is Laparoscopy an Option?

Abstract

Abstract Introduction: Radical cystectomy is the gold-standard treatment for urothelial and muscle invasive bladder cancer. Morbidity is high for this procedure, and ureteral stenosis with consequent renal damage is a possible complication for all types of urinary diversions. The endoscopic approach is a therapeutic option although it is not very effective. Open surgery is more effective, but is associated with significant morbidity. Laparoscopic approach has not been widely used because of its relative contraindication in patients with previous abdominal surgery, and because of its technical challenge. Purpose: To display the surgical technique, step by step, of the laparoscopic ureteroureterostomy in orthotopic neobladder. Materials and Methods: We present two cases of laparoscopic treatment of ureteral stenosis in patients who previously underwent laparoscopic radical cystectomy with orthotopic neobladder. Both patients developed right ureterohydronephrosis during the first year after the surgery. Endo...