Management of Urethral Strictures, Reimplants and Surgical Techniques for Ureter Reconstruction

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Divya Ajay, MD, MPH, Reconstructive Urologist, Memorial Sloan Kettering Cancer Center, New York, New York, focuses on strategies and considerations for lower ureteroplasty, emphasizing meticulous surgical technique and patient management.

In this 13-minute presentation, Dr. Ajay addresses various causes of ureteral pathology, including trauma, stones, infections, and malignancy. She stresses that successful outcomes depend on detailed preoperative planning, including a thorough understanding of stricture length after removing stents to avoid incomplete assessment.
Ajay outlines common surgical strategies with videos of procedures, including psoas hitch and Boari flap for distal ureteral reconstruction, and advocates for individualized approaches based on anatomy and patient history. The use of stents is debated, with newer evidence suggesting fewer complications in select cases when stents are avoided, though caution is recommended in complex or radiated patients.
Category
Urology
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