Introduction: Bilateral long ureteral strictures combined with a contracted bladder is rare. A 53-year-old female with history of cervical cancer underwent a neoadjuvant chemoradiotherapy and radical hysterectomy. She was presented with bilateral long ureteral strictures and contracted bladder, managed with double J-stent, and later with PCN. Additionally, severe intestinal adhesion and edema of this patient increased the difficulty of surgery.
Methods: Clinical and imaging examinations demonstrated bilateral long ureteral strictures with a contracted bladder. The patient underwent a completely intracorporeal robot-assisted laparoscopic bilateral ileal ureter replacement combined with ileal augmentation cystoplasty. This surgery included ureter localization and ureterotomy, ileal measurement and harvest, ileoureteral anastomosis, making U-shaped augmentation pouch, cystotomy and ileovesical anastomosis.
Results: The surgery lasted 361 minutes with estimated blood loss of 100 mL. The liquid food time was 3 days and the drainage tube was removed 6 days after surgery. The postoperative serum creatinine and estimated GFR were 0.94 mg/dl and 68.908 ml/min/1.73m2, respectively. No related short-term complications was observed.
Conclusions: Completely intracorporeal robot-assisted laparoscopic bilateral ileal ureter replacement combined with ileal augmentation cystoplasty is safe, effective and feasible to treat bilateral distal ureteral strictures with a contracted bladder. However, the long-term effect should be further investigated.
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.jpg "Xuesong Li, MD photo")