URETEROILEAL ANASTOMOTIC STRICTURES - AN INNOVATIVE APPROACH WITH METALLIC STENTS

Purpose: We report our experience with the use of self-expandable meta llic stents to bypass anastomotic strictures after ureteroileal urinar y diversion. Materials and Methods: We evaluated 3 men and 1 woman wit h invasive bladder carcinoma who underwent radical cystectomy and ilea l conduit urinary diversion. Ureteroenteric anastomotic strictures dev eloped after a mean of 16 months. Self-expandable metallic stents were successfully placed (bilaterally in 2) comprising 6 stented ureters t hat bypassed strictures. Mean patient age was 64 years and mean follow up was 12 months. Results: No restenosis was observed in 3 patients du ring followup. The stricture recurred 1 month after stent placement in the remaining patient and additional intervention was necessary, cons isting of placement of a totally coaxial overlapping metal stent. No s epsis or other complication was observed. One patient died of metastat ic disease 12 months after stent placement. Conclusions: We propose th e use of metal stents as an adequate, safe and effective alternative t reatment for anastomotic strictures after ureteroileal diversion.