RESULTS: In this article, we will review the most recent studies investigating UAS and evaluate etiology, potential risk factors, presentation, diagnosis, and management options, along with personal insight gained from our experience with managing this challenging reconstructive complication. Benign UAS is a relatively common long-term complication of intestinal urinary diversion, affecting approximately 1 in 10 patients. It is thought to be caused by ureteral tissue ischemia and fibrosis at the anastomotic site. Risk factors appear to include any that increase the likelihood of leak or ischemia; it is not clear if anastomotic approach impacts risk for stricture as well. Management options are varied and include endourologic, open, and robotic approaches. Endoscopic approaches may be less morbid but are considerably less effective than reconstruction performed after a period of ureteral rest.
结果:在本文中,我们将回顾调查UAS和评估病因的最新研究,潜在风险因素,介绍,诊断,和管理选项,以及从我们管理这种具有挑战性的重建并发症的经验中获得的个人见解。良性UAS是肠尿流改道的相对常见的长期并发症,影响大约十分之一的患者。它被认为是由吻合部位的输尿管组织缺血和纤维化引起的。风险因素似乎包括任何增加渗漏或缺血可能性的因素;目前尚不清楚吻合方法是否也会影响狭窄的风险。管理选项多种多样,包括内生逻辑,打开,和机器人方法。内窥镜入路的病态可能较少,但与输尿管休息一段时间后进行的重建相比,效果要少得多。