Percutaneous Transrenal Electro-Incision of Ureterointestinal Anastomotic Strictures: Long-Term Results and Comparison of Fluoroscopic and Endoscopic Guidance

AbstractPurpose: We determined the long-term outcome of a new technique for incising ureterointestinal anastomotic strictures using a transrenal percutaneously inserted papillotome. Procedures using fluoroscopic and endoscopic guidance were compared.Materials and Methods: Of 33 stenoses incised in 30 patients 15 were in ileal conduit diversions and 15 were in enterocystoplasties. The papillotome was inserted percutaneously over a guide wire into the stenosis, and then deflected and gently withdrawn under fluoroscopic (11 cases) or endoscopic (22) guidance using a flexible pediatric gastroscope or a lateral duodenoscope inserted retrograde into the ileal loop or neobladder. Air filling provided an excellent view of the stenotic area. Operative time did not exceed 45 minutes. The only major complication was damage to a right internal iliac artery.Results: Followup data were available for 31 stenoses, with 27 followed for longer than 12 months after stent removal. Of the stenoses 22 are completely patent (ac...