Combination of the Upper Urinary Tract and Bladder Drainage Methods after Laparoscopic Uretercystoneoanastomosis

Abstract The aim of the study was to evaluate the efficiency and safety of the upper urinary tract and bladder combination drainage method after laparoscopic uretercystoneoanastomosis. Introduction. Laparoscopic interventions have developed from a simple diagnostic procedure into complex reconstructive surgeries. One of the reconstructive procedures performed in urology is laparoscopic ureterocystoneoanastomosis or reimplantation of the ureter. The authors developed an alternative technique for drainage of the upper urinary tract and bladder during laparoscopic ureteroneocystostomy without the use of a ureteral stent. Material and methods. 40 patients who received surgical treatment of the lower third of the ureter stricture in the period from 2019 to 2022 were selected for the study. The mean age of all patients was 31.9 ± 14.0 years (M±δ). All patients were divided into 2 groups according to the upper urinary tract drainage method and intubation of the ureter. Group A consisted of 23 patients who were used a ureteral stent. Group B consisted of 17 patients who were performed the developed technique of a combination of bladder and ureter drainage of the upper urinary tract and intubation of the ureter. Results. The mean duration of surgery was lower when using a ureteral stent (103.3 ± 12.3 minutes versus 122.1 ± 14.0 minutes; M±δ). The analysis of intraoperative blood loss, intensity of postoperative pain and duration of inpatient treatment revealed no difference between the groups. The median duration for the removal of the urethral catheter in the group with a ureteral stent was lower than the new technique group (8 days versus 18 days). However, the median duration of ureteral intubation was lower with the new technique in comparison with the ureteral stent (18 days versus 29 days). The frequency of postoperative complications did not differ between the groups. Conclusion. The developed technique of combination drainage for the bladder and ureter during laparoscopic uretercystoneoanastomosis has similar efficacy and safety in compare with the use of an ureteral stent.

Hali tarjima qilinmagan