Upper Urinary Tract Decompression Using Ileal Ureter Replacement (IUR) In Comparison to Endoureteral Thermoexpandable Stent [Memokath® 051]
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Abstract
Background and Objective: The usage of permanent thermo-expandable stents and the definitive surgical treatment, like the ileal ureter replacement (IUR), both represent alternatives to repeated endourological stenting of long ureteral strictures.
We aimed to assess the long-term outcomes and complications of the IUR compared to the use of Memokath® 051 for ureteral reconstruction.
Material and Methods: In the last 10 years, two groups of patients with ureteral strictures (benign or malig-nant) have been followed up retrospectively. The first group presented with ureteral obstruction and was treated with an endoureteral thermo-expandable stent Memokath®, whereas the second group received an IUR as an alternative treatment method. All patients received follow-up examinations on an outpatient basis 3-4 weeks after hospital discharge, annual controls for long-term monitoring, and routine laboratory analysis and imaging of the upper urinary tract. The main outcome measure was the rate of successful upper tract decompression.
Results: Mean patient age for the first group was 59 years and 55 years for the second group. In the first group (17 patients, 27 renal units), long-term upper tract decompression was successful in 6 renal units (35%); the remaining patients required auxiliary measures and further interventions. In the second group (27 patients, 32 renal units), upper tract decompression was achieved in 24 (88.8%) patients. Secondary complications occurred in 4 (14.8%) patients. Renal function remained stable in 25 of the 27 patients, and metabolic acidosis was not observed.
Conclusion: The IUR is an effective reconstructive measure of the upper urinary tract with a low complication rate and decent long-term functional results. The IUR should be preferred to the Memokath, which can be seen as an alternative niche solution.
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