BUCCAL URETEROPLASTY FOR RECURRENT EXTENDED STRICTURES AND OBLITERATIONS IN THE UPPER URINARY TRACT: SHORT- AND LONG-TERM SURGERY OUTCOMES

Introduction. Buccal ureteroplasty is an operation that has been increasingly used in reconstructive urology in recent years. Its role becomes especially important due to the growing number of strictures of the upper urinary tract, which arise in association with the widespread use of endourological techniques. The article presents our own experience of using the oral mucosa in the surgical treatment of recurrent extended strictures and obliterations in the upper urinary tract. Aim. To study the short- and long-term outcomes of buccal ureteroplasty, complications of this operation, and methods for their correction. Materials and Methods. The treatment outcomes were studied in 37 patients who underwent 40 buccal ureteroplasties. The interventions differed in accesses, surgical techniques, and buccal graft revascularization methods. Postoperative complications were assessed according to the Clavien-Dindo classification of surgical complications. Results and Discussion. Early postoperative complications were detected in 16 patients (42.1%), and late complications in 10 patients (26.3%). All complications were Grades 1-23b according to this classification. The results obtained show that there were no severe complications in patients in the early and late postoperative periods, and there was a small number of obstruction relapses. Surgery efficacy was 91.2%; all subsequent relapses were successfully eliminated. Conclusions. Buccal ureteroplasty is an intervention that has a small number of severe complications and relapses and can be used to eliminate obstruction in the upper urinary tract.