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Buccal Mucosal Graft Ureteroplasty for Treatment of Proximal Ureteric Strictures, A Clinical Case Series.

NCT07797829 · Status: NOT_YET_RECRUITING · Phase: EARLY_PHASE1 · Type: INTERVENTIONAL · Enrollment: 25

Last updated 2026-09-03

No results posted yet for this study

Summary

While short strictures and even long strictures in the distal or mid-section of the ureter can easily be repaired by end-to-end anastomosis or simple re-implantation as well as standard procedures, such as psoas bladder hitch and/or Boari-flap, reconstructions of long proximal ureter remain rare and challenging (1), Although long segment proximal ureteric stricture (LPUS) have traditionally been managed with ileal ureter replacement (IUR) or renal auto transplantation (RA), these procedures may be technically difficult to perform and associated with considerable morbidity.(2) While buccal mucosa grafts (BMG) in urethral reconstruction are well established, only few small series for BMG in ureteric stricture have been reported. While showing promising results, these studies were flawed by inhomogeneous cohorts of patients with different kinds of strictures like uretero-pelvic junction (UPJ) obstruction, proximal and mid-ureter strictures that were treated with different techniques such as onlay ureteroplasty or augmented end-to-endanastomosis. Even though buccal mucosa harvesting is well established and straightforward current guidelines still do not recommend BMG ureteroplasty as an equal alternative to more invasive alternatives such as ileum interposition or renal auto-transplantation. (3) In 1999, Naude (4) introduced an alternative and innovative technique for treating ureteric strictures by utilizing buccal mucosa grafts (BMG) in conjunction with omental wrapping. Implementing onlay BMG during ureteral reconstruction eliminates the necessity for extensive ureterolysis, reducing disruption to the peri-ureteral blood supply. Furthermore, the BMG can be customized to accommodate the dimensions of the ureteral defect, ensuring a tension-free anastomosis. (5)

Conditions

  • Ureter Stricture

Interventions

PROCEDURE

Buccal mucosal graft ureteroplasty

Ureteric Exposure and Stricturoplasty The affected ureteric segment is approached (open flank) for upper third and Abernathy for middle ureteric stricture. and the stricture is identified and confirmed. The ureter is opened longitudinally (ureterotomy) with no. 11 blade across the full length of the stricture guided by the catheter onto 1 cm of healthy tissue proximally and distally. In short tight areas with maximal narrowing \<1 cm, mucosa is excised and mucosa to mucosa anastomosis is done. The prepared BMG is fashioned onto the ureterotomy defect (onlay technique) or configured as an augmentation patch and secured with vicryl 5-0 continuous absorbable sutures over a silicon 6/26 Dj stent. A double-J ureteric stent is placed across the repaired segment prior to completion of the graft inset to splint the reconstruction and ensure adequate drainage during graft take. Omental wrap or peri-ureteric fat/tissue coverage of the graft is performed where feasible to enhance graft vasculariza

Sponsors & Collaborators

  • Mohamed Salah Abdul Mawgoud

    lead OTHER

Study Design

Allocation
NA
Purpose
TREATMENT
Masking
NONE
Model
SINGLE_GROUP

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2026-09-15
Primary Completion
2027-03-15
Completion
2028-03-15

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07797829 on ClinicalTrials.gov