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• W3022097777 abstract "You have accessJournal of UrologyBladder Cancer: Invasive V (PD55)1 Apr 2020PD55-06 EPIDEMIOLOGICAL DESCRIPTION AND MANAGEMENT OUTCOMES OF BENIGN URETEROENTERIC STRICTURE AFTER RADICAL CYSTECTOMY: A SINGLE-CENTRE EXPERIENCE Jose Mari Gaya*, Christian Martinez Osorio, Iacopo Meneghetti, Andres Caillabet, Davide Vanacore, Matteo Talle, Lucia Mosquera, Jorge Huguet, Antonio Rosales, Joan Palou, and Alberto Breda Jose Mari Gaya*Jose Mari Gaya* More articles by this author , Christian Martinez OsorioChristian Martinez Osorio More articles by this author , Iacopo MeneghettiIacopo Meneghetti More articles by this author , Andres CaillabetAndres Caillabet More articles by this author , Davide VanacoreDavide Vanacore More articles by this author , Matteo TalleMatteo Talle More articles by this author , Lucia MosqueraLucia Mosquera More articles by this author , Jorge HuguetJorge Huguet More articles by this author , Antonio RosalesAntonio Rosales More articles by this author , Joan PalouJoan Palou More articles by this author , and Alberto BredaAlberto Breda More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000965.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroenteric anastomosis stricture (UES) is a common complication, between 3-10%, after radical cystectomy (RC). Although open ureteral reimplantation is the gold standard treatment, endoscopic approach and laparoscopic-robotic reimplantation have achieved popularity in the last decades. Predictors of success of every treatment option are poorly defined. Our objectives were to characterize the UES and outcomes after its treatment and identify risk factors for treatment failure and UES recurrence. METHODS: We performed a retrospective review of 111 patients with UES after RC, diagnosed between August 1999 and February 2019 in a single-centre. Baseline clinicopathologic characteristics, details of UES, and perioperative outcomes were collected and analysed. Predictors for stricture recurrence and treatment failure were assessed by univariable testing and multivariable stepwise regression. RESULTS: Between May 1990 and October 2018, 2520 RC were performed in our centre, of which 111 patients (4.4%) were diagnosed with benign UES with intention to treat. Among these, 59 (53.2%) patients developed a stenosis in the left ureter, 23 in the right (20.7%) and 29 (26.1%) bilaterally. The median time to primary UES was 8.3 months (range 0.5 - 377.2 months) and 30 (27%) patients were asymptomatic. 79 (71.2%) patients required emergency nephrostomy tube before primary treatment and 49 patients were cured (44.1%) with the primary treatment. In 84 (75.7%) patients there was an intention to treat endoscopically as a primary treatment and in 51 cases the treatment was completed, with a success rate of 33.3%. 15 (13.5%) patients went to primary open or laparoscopic surgical correction with a success rate of 93.3%. After failure of primary endoscopic management, 19 (28.36%) went to endoscopic management again, with a success rate of 26.3% and 25 (37.31%) underwent ureteral reimplantation with a success rate of 76%. 180-day Major complications (Clavien> 3a) were found in 3 (20%) patients treated with primary ureteral reimplantation and in no patient who underwent endoscopic management. The multivariate analysis showed bilateral UES, endoscopic primary treatment and time to UES less than 6 months were independent risk factors for failure primary treatment. CONCLUSIONS: Endoscopic approach is a safe alternative treatment of UES with acceptable results and very low comorbidity. Although success rate is not as high as reconstructive surgery, endoscopic failure does not affect subsequent results of open or laparoscopic surgical correction. Identification of risk factors of endoscopic treatment failure could help to provide better patient selection in order to improve success rate. Source of Funding: No. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1184-e1184 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jose Mari Gaya* More articles by this author Christian Martinez Osorio More articles by this author Iacopo Meneghetti More articles by this author Andres Caillabet More articles by this author Davide Vanacore More articles by this author Matteo Talle More articles by this author Lucia Mosquera More articles by this author Jorge Huguet More articles by this author Antonio Rosales More articles by this author Joan Palou More articles by this author Alberto Breda More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W3022097777 title "PD55-06 EPIDEMIOLOGICAL DESCRIPTION AND MANAGEMENT OUTCOMES OF BENIGN URETEROENTERIC STRICTURE AFTER RADICAL CYSTECTOMY" @default.
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