Uretero-vesical anastomotic stricture. A case report and review of management

Mathew Yamoah Kyei; Robert Djagbletey; George Oko  Klufio; James Edward Mensah; Bernard Toboh

doi:10.46829/hsijournal.2021.6.2.1.210-214

Mathew Yamoah Kyei Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
Robert Djagbletey Department of Anaesthesia, University of Ghana Medical School, University of Ghana, Accra, Ghana
George Oko Klufio Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
James Edward Mensah Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
Bernard Toboh Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana

DOI: https://doi.org/10.46829/hsijournal.2021.6.2.1.210-214

Keywords: uretero-vesical anastomosis, ureteroneocystostomy, stricture, endoscopic treatment

Abstract

Uretero-vesical anastomosis is the connection of the ureter to the urinary bladder at a new site so as to achieve unimpeded flow of urine from the ureters into the urinary bladder. A rare complication of this procedure is the development of stricture at the anastomotic site.

This report is on a 62 year old female with one year history of left flank pain and a prior left uretero-vesical anastomosis 14 years earlier. She had been managed as recurrent urinary tract infection without pain relief. Abdomen pelvic CT Scan with intravenous urogram helped establish the diagnosis of uretero-vesical anastomotic stricture. This was successfully managed with endoscopic dilatation after placement of a guide wire retrogradely under fluoroscopy followed by serial dilation.

In a patient presenting with flank pains after a previous uretero-vesical anastomosis, stricture at the anastomotic site is an important differential diagnosis. Endoscopic management is the preferred initial management with good success.