Ureteral Reconstruction with Decellularized Small Intestinal Submucosa Matrix for Ureteral Stricture: A Preliminary Report of Two Cases

Objective: To determine the feasibility of decellularized small intestinal submucosa (SIS) matrix in repairing ureteral strictures.

Methods: Two patients with ureteral stenoses underwent ureteral reconstruction with SIS matrix at the Zhejiang Provincial Corps Hospital of Chinese People's Armed Forces between June 2014 and June 2016. The ureteral stenoses were repaired with a semi-tubular SIS matrix and the postoperative recoveries were observed.

Results: Both operations were successfully completed. The average operative time was 90 min and the average length of hospital stay was 15 days. No fevers, incision infections, intestinal obstruction, graft rejection, or other serious complications were noted. After 2 months, ureteroscopic examinations showed that the surfaces of the original patches were covered by mucosa and there were no apparent stenoses in the lumens. The ureteral stents were replaced every 2 months postoperatively and removed 12 months postoperatively. No infections or urinary leakage occurred after removal of the stents. Intravenous urography was performed 6 and 12 months postoperatively. The results showed that the ureters were not obstructed and there was no apparent stenosis at the anastomosis sites. The average follow-up time was >12 months. Long-term follow-up is still ongoing, and computed tomography examinations of the urinary tract have been conducted in the outpatient department of our hospital 1, 3, and 6 months after removal of the double-J stents, suggesting the absence of hydronephrosis. The serum creatinine levels remained stable during the follow-up.

Conclusion: SIS matrix reconstruction is a feasible method to repair ureters stenosis.