Impact of radiation on the incidence and management of ureteroenteric strictures: a contemporary single center analysis

Ureteroenteric stricture incidence has been reported as high as 20% after urinary diversion. Many patients have undergone prior radiotherapy for prostate, urothelial, colorectal, or gynecologic malignancy. We sought to evaluate the differences between ureteroenteric stricture occurrence between pati...

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Bibliographic Details
Published in:BMC urology 2021-08, Vol.21 (1), p.101-101, Article 101
Main Authors: Yeaman, Clinton T, Winkelman, Andrew, Maciolek, Kimberly, Tuong, Mei, Nelson, Perri, Morris, Chandler, Culp, Stephen, Isharwal, Sumit, Krupski, Tracey L
Format: Article
Language:English
Subjects:
Aged
Angiography
Asymptomatic
Body mass index
Constriction, Pathologic - epidemiology
Constriction, Pathologic - etiology
Databases, Factual
Endoscopy
Female
Humans
Hydronephrosis
Implants
Incidence
Ischemia
Male
Malignancy
Microvasculature
Middle Aged
Nephrostomy, Percutaneous
Pathology
Patients
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Prospective Studies
Prostate
Prostate cancer
Radiation
Radiation therapy
Radiotherapy
Radiotherapy - adverse effects
Risk Factors
Robotic surgery
Robotics
Statistical analysis
Stricture
Surgeons
Ureter - radiation effects
Ureteral Obstruction - epidemiology
Ureteral Obstruction - etiology
Ureteral stents
Ureteroenteric
Urinary diversion
Urinary Diversion - adverse effects
Urology
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Summary:Ureteroenteric stricture incidence has been reported as high as 20% after urinary diversion. Many patients have undergone prior radiotherapy for prostate, urothelial, colorectal, or gynecologic malignancy. We sought to evaluate the differences between ureteroenteric stricture occurrence between patients who had radiation prior to urinary diversion and those who did not. An IRB-approved cystectomy database was utilized to identify ureteroenteric strictures among 215 patients who underwent urinary diversion at a single academic center between 2016 and 2020. Chart abstraction was conducted to determine the presence of confirmed stricture in these patients, defined as endoscopic diagnosis or definitive imaging findings. Strictures due to malignant ureteral recurrence were excluded (3 patients). Statistical analysis was performed using chi squared test, t-test, and Wilcoxon Rank-Sum Test, logistic regression, and Kaplan-Meier analysis of stricture by cancer type. 65 patients had radiation prior to urinary diversion; 150 patients did not have a history of radiation therapy. Benign ureteroenteric stricture rate was 5.3% (8/150) in the non-radiated cohort and 23% (15/65) in the radiated cohort (p =  
ISSN:1471-2490
1471-2490
DOI:10.1186/s12894-021-00869-6