The Surgical Management of Bilharzial Strictures of the Ureter

Abstract

Twenty-one ureteric strictures due to bilharzia have been treated surgically in 13 patients. Two required nephrectomy; 19 had direct ureteric reimplantation into the dome of the bladder after excision of the strictured segment of ureter. A simple technique of reimplantation into the dome of the bladder is described and early results have justified its further use.

Full‐length Ureteric Splintage in the Management of Bilharzial Ureteric Strictures

“…Vesico-ureteric reflux is unusual in bilharziasis, and simple domal vesico-ureteric implantation has been reported to be safe and non-reflux-inducing (Mee and Youssef, 1982).…”

“…In vesico-ureteric implantation, since only the most involved distal ureteric segment is excised and the remaining diseased ureter is used for the anastomosis, there is a risk of re-stenosis (Mee and Youssef, 1982). Ileal loop replacement has a limited place in the management of ureteric strictures and is associated with significant morbidity and mortality (Weinberg, 1970;Ghoneim and Shoukry, 1972).…”

“…Urinary schistosomiasis can be associated with ureteric strictures (Mee and Youssef, 1982) and bladder carcinoma (El Bolkainy, 1981). Bothlesions carry significant morbidity and mortality.…”

Surgical. Correction of Bilharzial Ureteric Stricture by Boari Flap Technique

“…The success rate of Boari flap surgery for extensive bilharzial ureteric strictures was highly satisfactory when compared with the success rates of other surgical approaches (Maged, 1971 ;Smith et al, 1977;Elbaz and Badr, 1982;Mee and Youssef, 1982;Bazeed et al, 1983;A1 Shukri and Alwan, 1983;Jacobson et al, 1987;Rady and Rady, 1987;Wishahi, 1987;Awad et al, 1989).…”

Use of a Ureteric Nipple in the Surgical Management of Bilharzial Ureteric Strictures

“…In the absence of severe structural damage to the affected ureters, such patients are usually managed by vesicoureteric reimplantation, but the gross dilatation of the ureters and the intense periureteritis make it difficult and dangerous to use an anti-refluxing type of reimplantation by submucosal tunnelling. Fam (1964) Table Salient Features of the 10 Patients to-side ureterovesical anastomosis which has been widely employed in bilharzial surgery (Ghoneim et ai., 1971;Mee and Youssef, 1982). Urquhart-Hay et al (1977) have recently reported the anti-reflux potential of vesicoureteric reimplantation by constructing a nipple from a dilated ureter without submucosal tunnelling.…”