Multi-institutional data analysis and literature review of comparative outcomes of autologous ureteral substitution techniques.
5 affiliations
- 1School of Medicine, St. George's University, St. George's, Grenada.
- 2Department of Emergency Medicine, Freeman Health System, Joplin, Missouri, USA.
- 3Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
- 4Department of Urology, University of Florida College of Medicine - Jacksonville, Jacksonville, Florida, USA.
- 5Department of Urology, Northwell Health, New York, New York, USA.
Abstract
Introduction
Complex ureteral strictures often require substitution techniques to preserve renal function. Multiple autologous reconstruction options exist, yet comparative outcome data across techniques remain limited.Material and methods
This multicenter retrospective cohort study included 168 patients who underwent ureteral reconstruction using ileal interposition, Yang-Monti tabularization, appendiceal interposition, or fallopian tube substitution. Preoperative, intraoperative, and postoperative variables were analyzed. Renal function outcomes were assessed using serum creatinine and estimated glomerular filtration rate (GFR). Complications were classified according to the Clavien-Dindo system.Results
Postoperative renal function improved significantly across the cohort, with mean creatinine decreasing from 2.19 ±1.35 mg/dl to 1.68 ±0.93 mg/dl (p <0.001) and mean GFR increasing from 58.3 ±17.4 ml/min to 65.6 ±15.0 ml/min (p <0.001). No statistically significant differences were observed among reconstruction techniques in renal outcomes, complication rates, or operative variables (p >0.05). Electrolyte disturbances (12%) and infections (11%) were the most common complications.Conclusions
Ileal, Yang-Monti, appendiceal, and fallopian tube ureteral substitutions demonstrate comparable outcomes in renal preservation and complication profiles. These findings support individualized surgical decision-making based on patient-specific factors rather than inherent superiority of a specific technique.
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BibTeX
@article{hildebrand2026multiinstitutional,
title = {{Multi-institutional data analysis and literature review of comparative outcomes of autologous ureteral substitution techniques.}},
author = {Brooke Hildebrand and Neerja Tillu and Maurizio Buscarini and Arjun Venkatesh and Arshia Rangchi and Zachary Dovey and Ahmed Rabie and Osama Zaytoun},
journal = {Central European journal of urology},
year = {2026},
month = jun,
doi = {10.5173/ceju.2025.0279},
url = {https://europepmc.org/article/MED/42904080},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Multi-institutional data analysis and literature review of comparative outcomes of autologous ureteral substitution techniques.
AU - Brooke Hildebrand
AU - Neerja Tillu
AU - Maurizio Buscarini
AU - Arjun Venkatesh
AU - Arshia Rangchi
AU - Zachary Dovey
AU - Ahmed Rabie
AU - Osama Zaytoun
PY - 2026
DA - 2026/06/14
JO - Central European journal of urology
DO - 10.5173/ceju.2025.0279
UR - https://europepmc.org/article/MED/42904080
AB - Introduction Complex ureteral strictures often require substitution techniques to preserve renal function. Multiple autologous reconstruction options exist, yet comparative outcome data across techniques remain limited.Material and methods This multicenter retrospective cohort study included 168 patients who underwent ureteral reconstruction using ileal interposition, Yang-Monti tabularization, appendiceal interposition, or fallopian tube substitution. Preoperative, intraoperative, and postoperative variables were analyzed. Renal function outcomes were assessed using serum creatinine and estimated glomerular filtration rate (GFR). Complications were classified according to the Clavien-Dindo system.Results Postoperative renal function improved significantly across the cohort, with mean creatinine decreasing from 2.19 ±1.35 mg/dl to 1.68 ±0.93 mg/dl (p <0.001) and mean GFR increasing from 58.3 ±17.4 ml/min to 65.6 ±15.0 ml/min (p <0.001). No statistically significant differences were observed among reconstruction techniques in renal outcomes, complication rates, or operative variables (p >0.05). Electrolyte disturbances (12%) and infections (11%) were the most common complications.Conclusions Ileal, Yang-Monti, appendiceal, and fallopian tube ureteral substitutions demonstrate comparable outcomes in renal preservation and complication profiles. These findings support individualized surgical decision-making based on patient-specific factors rather than inherent superiority of a specific technique.
SN - 2080-4806
SN - 2080-4873
ER -