Getting out of a tight spot: an overview of ureteroenteric anastomotic strictures

Nat Rev Urol. 2016 Aug;13(8):447-55. doi: 10.1038/nrurol.2016.104. Epub 2016 Jun 28.

Abstract

Radical cystectomy and urinary diversion is the gold-standard treatment for muscle-invasive and high-risk non-muscle-invasive bladder cancer. Ureteroenteric anastomotic stricture is a well-known complication of urinary diversion and is associated with serious sequelae that lead to total or partial loss of kidney function, infectious complications, and the need for additional procedures. Although the exact aetiology of benign ureteroenteric anastomotic strictures is unclear, they most likely occur secondary to ischaemia at the anastomotic region. Diagnosis can be achieved using retrograde contrast studies, CT scan or MAG3 renography. Open revision remains the gold-standard treatment for ureteroenteric anastomotic strictures; however, endourological techniques are being increasingly used and, in select patients, might be the optimal approach.

Publication types

  • Review

MeSH terms

  • Anastomosis, Surgical / adverse effects*
  • Anastomosis, Surgical / trends
  • Constriction, Pathologic / diagnostic imaging
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Cystectomy / adverse effects*
  • Cystectomy / trends
  • Humans
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*
  • Ureter / diagnostic imaging
  • Ureter / surgery*
  • Ureteral Obstruction / diagnostic imaging
  • Ureteral Obstruction / etiology
  • Ureteral Obstruction / surgery
  • Urinary Diversion / adverse effects*
  • Urinary Diversion / trends