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IP45-08 OUTCOMES OF URETERAL RECONSTRUCTION UTILIZING THE TRAUMA AND UROLOGIC RECONSTRUCTION NETWORK OF SURGEONS CLSE URETERAL STRICTURE CLASSIFICATION SYSTEM
Abstract   Peer reviewed

IP45-08 OUTCOMES OF URETERAL RECONSTRUCTION UTILIZING THE TRAUMA AND UROLOGIC RECONSTRUCTION NETWORK OF SURGEONS CLSE URETERAL STRICTURE CLASSIFICATION SYSTEM

Dhruv Puri, Nishant Garg, Shawn Grove, Sweta Parija, Kshitij Pandit, Anh Nguyen, Alex J. Vanni, Anna Saltman, Nejd Alsikafi, Bryan Voelzke, …
The Journal of urology, Vol.215(5S), p.e916
05/2026
DOI: 10.1097/01.JU.0001191548.79667.9d.08

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Abstract

INTRODUCTION AND OBJECTIVES: Using common nomenclature and a classification system will aid in the understanding of upper tract reconstruction. This study evaluated the recurrence-free survival (RFS) and postoperative improvement in hydronephrosis by stricture length, segment and etiology following ureteral reconstruction. METHODS: A multi-institutional dataset of 777 patients undergoing ureteral reconstruction was retrospectively analyzed. Demographics, etiologies (multiple categories may apply to a single stricture), operative features, and outcomes were reviewed. RFS was assessed using Kaplan–Meier analysis with log-rank testing. Radiographic outcomes were quantified by changes in SFU hydronephrosis grade between baseline and 3-month follow-up imaging. RESULTS: Mean age was 52.3 ± 16.5 years, and mean follow-up was 13.5 months. 51.6% of the reconstructions used a tissue transfer technique. The overall 12-month recurrence-free survival (RFS) exceeded 90% across all etiologies, with radiation induced strictures demonstrating a lower RFS (log-rank p=0.0139). Length, segment and modifiers did not predict recurrence (p>0.05). Hydronephrosis improved markedly across all etiologies (p<0.05 for all). Overall, 30-day complication rate was 20.5%, most commonly UTIs. Among 29 recurrences (3.7%), reinterventions included percutaneous nephrostomy (45%), repeat reconstruction (28%), stenting (10%), and endoscopic dilation/incision (3%). CONCLUSIONS: Ureteral reconstruction achieved excellent short-term outcomes across all etiologies, 1-year recurrence-free survival and significant radiographic improvement in hydronephrosis. Radiation-associated strictures demonstrated higher recurrence risk.

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