Ureteral stricture disease is a general term for ureteral lumen stenosis or atresia, which caused by congenital dysplasia, iatrogenic injury, impacted residual ureteral stones, tumor radiotherapy or other reasons. It leads to varying degrees of hydronephrosis or impaired renal function on the affected side. The management of long, complex proximal ureteral strictures is challenging in clinical practice. Techniques such as ileal ureteral replacement and renal autotransplantation have shortcomings of large injure and lethal complications, while palliative therapy may seriously affect the quality of life of patients. Thus, development of minimally invasive surgical techniques for ureteral reconstruction is urgently needed.
In 2015, the team of Professor Li Bing from the Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, performed the lingual mucosal graft ureteroplasty (LMGU) for long proximal ureteral stricture, this is the first case of using of lingual mucosal graft for ureteral reconstraction (Journal of Clinical Urology, 2015; Int Urol Nephrol, 2016). The application of this operation enables some patients to avoid ileal ureteral replacement or renal autotransplantation which can result in large injure or complications. The team then conducted strict follow-up regime and accumulated experience for years.
By 2022, the overall success rate was 97.6% among 41 cases during six years, and the relative renal function of 20 patients after a median 4-year (48.3 mo) of follow-up remained stable or improved compared with before. On May 23, the retrospective study involved data for 41 patients treated with LMGU was published in European Urology (IF: 20.096) (entitled ‘Lingual mucosal graft ureteroplasty for long proximal ureteral stricture: six years of experiences with 41 cases'), giving an introduction of the indications, preoperative preparation, surgical procedures and key techniques, as well as the postoperative patient management and follow-up results of lingual mucosal graft ureteroplasty for long proximal ureteral stricture, to provide technical reference for the field of urological repair and reconstruction.
Written by: Department of Urology
Edit by: International Exchange Office