Document Type

Article

Publication Title

Central European Journal of Urology

Abstract

Introduction

Complex ureteral strictures often require substitution techniques to preserve renal function. Multiple autologous reconstruction options exist, yet comparative outcome data across techniques remain limited.

Material and methods

This multicenter retrospective cohort study included 168 patients who underwent ureteral reconstruction using ileal interposition, Yang–Monti tabularization, appendiceal interposition, or fallopian tube substitution. Preoperative, intraoperative, and postoperative variables were analyzed. Renal function outcomes were assessed using serum creatinine and estimated glomerular filtration rate (GFR). Complications were classified according to the Clavien–Dindo system.

Results

Postoperative renal function improved significantly across the cohort, with mean creatinine decreasing from 2.19 ±1.35 mg/dl to 1.68 ±0.93 mg/dl (p <0.001) and mean GFR increasing from 58.3 ±17.4 ml/min to 65.6 ±15.0 ml/min (p <0.001). No statistically significant differences were observed among reconstruction techniques in renal outcomes, complication rates, or operative variables (p >0.05). Electrolyte disturbances (12%) and infections (11%) were the most common complications.

Conclusions

Ileal, Yang–Monti, appendiceal, and fallopian tube ureteral substitutions demonstrate comparable outcomes in renal preservation and complication profiles. These findings support individualized surgical decision-making based on patient-specific factors rather than inherent superiority of a specific technique.

DOI

10.5173/ceju.2025.0279

Publication Date

6-14-2026

Keywords

ureteral substitution, reconstructive urology, renal preservation, bowel interposition, Yang–Monti technique

ISSN

2080-4873

Download

Share

COinS