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IP45-24 A MULTI-INSTITUTIONAL ANALYSIS OF REVISION SURGERY AMONG PATIENTS WITH PRIOR URETERAL RECONSTRUCTION
Abstract   Peer reviewed

IP45-24 A MULTI-INSTITUTIONAL ANALYSIS OF REVISION SURGERY AMONG PATIENTS WITH PRIOR URETERAL RECONSTRUCTION

Sweta Parija, Shawn Grove, Dhruv Puri, Nishant Garg, Kshitij Pandit, Anh Nguyen, Jeremy Myers, Salt Lake City, Benjamin Mccormick, Sima Daryabari, …
The Journal of urology, Vol.215(5S), p.e924
05/2026
DOI: 10.1097/01.JU.0001191548.79667.9d.24

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Abstract

INTRODUCTION AND OBJECTIVES: While primary ureteral reconstruction generally yields high success rates, a subset of patients experience recurrent stricture requiring revision surgery. Characterization of operative details and success following revision procedures remain limited. Our study aims to analyze demographics, outcomes, and complications of revision ureteral reconstruction. METHODS: A multi-institutional retrospective review evaluated 78 patients from 7 centers who underwent revision ureteral surgery between 2013 and 2025 for recurrent ureteral stricture treated with a prior ureteral reconstruction. Recurrence was determined by the need for reintervention. Univariate associations were evaluated using Fisher’s exact test, and multivariate associations were evaluated using Firth logistic regression. Unpaired t-tests compared pre- and postoperative GFR, creatinine, MAG3 renal scan results, and SFU hydronephrosis grade, with significance set at p<0.05. RESULTS: Mean age was 48.96 ± 15.21 years, and mean follow-up was 13.29 months (Table 1). Twelve-month recurrence free survival was 92.31% (Table 2). On univariate analysis, infection/fibrosis etiologies were associated with increased recurrence risk (p<0.01). This was consistent on multivariate analysis when controlling for age, BMI, smoking, and repair type (OR 18.10, p-value < 0.01). Age, BMI, smoking, comorbidities, and operative characteristics were not significantly associated with recurrence on univariate analysis. Postoperative SFU hydronephrosis grade was significantly lower than preoperative (95% CI, 1.78–2.98; p<0.001). No significant differences were observed in GFR, creatinine, or MAG3 renal scan. The overall complication rate was 18.75%, with urinary tract infections being the most common. CONCLUSIONS: Revision ureteral reconstruction procedures show high rates of success. Renal function was preserved following secondary surgery, with notable improvement in hydronephrosis outcomes. While infection/fibrosis etiologies may be related to retreatment, wide confidence intervals underscore the need for studies with larger sample sizes.

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