Functional state of lower urinary tract after reconstructive surgery operations on pelvic ureter

Aim: to investigate the functional state of lower urinary tract after various types of reconstruction in patients with long ureteral stenosis. Materials and methods: this study included 175 patients with lengthy strictures of the pelvic ureter, who were operated in the urology clinic of NWSMU named after Mechnikov I.I. in period of 1998-2014. All patients were divided into 3 groups. First group consisted of 102 (58.3%) patients, which had a Boari ureteroplasty, second group - 54 (30.1%) patients with intestinal ureteroplasty and third - 19 (10.9%) patients with appendicular ureteroplasty. All patients underwent urodynamics before operation and thereafter, even in case of absence of any complaints. Kidney and lower urinary tract functions were estimated early postop and further during the follow-up using laboratory, nuclear and endourological investigations. Results: In group of Boari patients a significant decrease in bladder capacity and compliance was detected at 12 months postop. At that overactive bladder symptoms were present in form of frequency and urgency. Conclusions: this urodynamics-based study showed the advantages of the intestinal and appendicular substitutions of ureter in comparison with flap techniques, which were related to the fact that reconstructions using the bladder wall led to decrease in the functional capacity and compliance, overactive bladder symptoms and vesico-ureteral reflux.