70 Central European Journal of Urology VIDEOABSTRACT videosurgery Video can be found at http://ceju.online/journal/2022/endoscopic-ureteral-stricture-ureteroenteric-stricture-cystectomy-2249.php Endourological treatment of uretero-enteric benign stricture after radical cystectomy and kidney transplant Angelo Territo1, Paolo Verri1, Alessandro Uleri1, Pietro Diana1, Andrea Gallioli1, Michael Baboudjian1–4, Josep Maria Gaya1, Francesco Sanguedolce1, Julia Aumatell1, Giuseppe Basile1, Alejandra Bravo1, Joan Palou1, Alberto Breda1 1 Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain 2 Department of Urology, APHM, North Academic Hospital, Marseille, France 3 Department of Urology, APHM, La Conception Hospital, Marseille, France 4 Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France Article history Submitted: Nov. 22, 2022 Accepted: Nov. 27, 2022 Published online: Dec. 9, 2022 Citation: Territo A, Verri P, Uleri A, et al. Endourological treatment of uretero-enteric benign stricture after radical cystectomy and kidney transplant. Cent European J Urol. 2023; 76: 70. Key Words: endoscopic ‹› ureteral stricture ‹› uretero-enteric stricture ‹› cystectomy ‹› kidney transplant Benign ureteral stricture after radical cystectomy is and identify the stricture. Endoscopic balloon dila- a common post-operative complication. In case this tion was performed reaching a pressure of 30 atmo- scenario occurs in kidney-transplanted patients, the spheres. After inspection, the stricture was incised surgeon needs to face a challenging anatomy and with thulium laser (15–20 W) until exposure of peri- the obligation of nephron preservation. We present ureteral fat. A second dilation was performed to en- a 76-year-old male that underwent open renal trans- sure successful treatment. A uni-J ureteral catheter plantation in 2019 and open radical cystectomy with (8 Fr) was left for 1 week. After 30 days, anterograde ileal conduit in 2021 for a high-grade pT3N0M0 uro- pyelography (via nephrostomy tube) was carried out thelial tumor. After four months, the patient pre- demonstrating the stenosis resolution. sented with worsening renal function (glomerular In conclusion, the endoscopic treatment of ureter- filtration rate 21 mL/min/1.73 m2) and grade III–IV enteric benign strictures in renal transplant patients graft hydronephrosis at computed tomography scan. after radical cystectomy is feasible and safe with opti- A nephrostomy tube was placed, and anterograde mal outcomes. Renal function preservation is the ulti- pyelography showed a <1 cm stricture of the distal mate goal in these patients and the endourological ap- ureter. proach represents an alternative effective technique. The surgical steps were the following. The patient was placed in supine position. Two Amplatz guide- Conflicts of interest wires were placed through a dual lumen ureteral The authors declare no conflicts of interest. access catheter (5–10 Fr and a length of 24 cm) af- ter nephrostomy tube removal. After positioning of Corresponding author a ureteral access sheath (10–12 Fr) an antegrade Alessandro Uleri flexible-ureterorenoscopy was performed to reach alessandrouleri@outlook.it Cent European J Urol. 2023; 76: 70 This is an Open Access article distributed under the terms of the Creative Commons doi: 10.5173/ceju.2022.238 Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/).