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Minimal-invasive ileal ureter replacement for the management of multiple ureteral polyps: the initial experience

  • Urology - Original Paper
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Abstract

Purpose

To present our initial experience in the management of multiple ureteral polyps with robotic or laparoscopic ileal ureter replacement (IUR).

Methods

Eight consecutive patients diagnosed with multiple ureteral polyps underwent robotic or laparoscopic IUR between July 2019 and November 2022. Unilateral IUR was performed in 5 patients with polyps in the left (n = 3) or right (n = 2) side, and 3 patients with bilateral multiple polyps underwent bilateral IUR. Demographic characteristics, perioperative data and follow-up outcomes were prospectively collected.

Results

A cohort of 5 male and 3 female patients (11 ureters) with a mean age of 32.8 ± 11.3 years were included. Among these patients, 5 presented with recurrent flank pain, 1 had hematuria, and 2 were asymptomatic. Four patients experienced prior failed surgical interventions. The mean length of diseased ureter was 11.9 ± 4.7 cm, with more than 10 cm in eight sides. All procedures were performed successfully. The mean operation time was 319 ± 87.6 min with 3 patients who simultaneously underwent intraoperative ureteroscopy. The mean length of ileal graft was 23.8 ± 5.8 cm. During the mean follow-up of 20.4 ± 12.8 months, one major complication, specifically incision infection, and four minor complications, including urinary infection (n = 3) and metabolic acidosis (n = 1), were observed. All patients presented symptom-free, with improved/stabilized hydronephrosis and no signs of restenosis.

Conclusion

Robotic or laparoscopic IUR is a feasible, safe, and effective surgical option for patients with long ureteral defects caused by multiple polyps.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

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Author notes

  1. Xiang Wang, Yiming Zhang, and Jilong Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China

    Xiang Wang, Yiming Zhang, Jilong Zhang, Zhihua Li, Guanpeng Han, Lianghao Zhang, Xinfei Li, Kunlin Yang, Bing Wang, Liqun Zhou, Kai Zhang & Xuesong Li

  2. Department of Nursing, Peking University First Hospital, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China

    Zhihua Li

  3. Department of Urology, Emergency General Hospital, No. 29 Xibahenanli St, Chaoyang District, Beijing, 100020, China

    Peng Zhang

  4. Department of Urology, Beijing Jiangong Hospital, No. 6 Rufuli St, Xicheng District, Beijing, 100034, China

    Chen Huang, Jing Liu & Hongjian Zhu

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  1. Xiang Wang
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Contributions

XW, KZ, and XSL were involved in the project conception and design. XW, YMZ, JLZ, ZHL, GPH, LHZ, BW, PZ, CH, and JL contributed to the data acquisition. XW, JLZ, and YMZ assisted in the data analysis, statistical analysis and interpretation. XW and YMZ helped in the manuscript drafting. XFL, KLY, HJZ, LQZ, KZ, and XSL contributed to the critical revision of the manuscript for scientific and factual content. KZ and XSL were involved in the supervision.

Corresponding authors

Correspondence to Kai Zhang or Xuesong Li.

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Ethical approval

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All patients included in this study were provided with informed consent prior to participation, which was carried out in accordance with the Principles of the Declaration of Helsinki. This study was approved by the Ethics Committee of Peking University First Hospital (approval number: 2019Yan134).

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Wang, X., Zhang, Y., Zhang, J. et al. Minimal-invasive ileal ureter replacement for the management of multiple ureteral polyps: the initial experience. Int Urol Nephrol 56, 1919–1926 (2024). https://doi.org/10.1007/s11255-023-03850-4

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