LAUSR

OBJECTIVE To report our initial experience with ureteral appendiceal interposition (UAI) in a series of adult patients undergoing ureteral reconstruction for ureteral stricture. METHODS We retrospectively collected data of patients who underwent UAI for ureteral stricture disease from December 2015 to March of 2020. Success of surgery was defined as one that required no subsequent procedural intervention for recurrent ureteral stricture disease, or loss of kidney function. RESULTS Eleven patients underwent UAI for ureteral stricture. Etiologies for stricture disease included radiation exposure, nephrolithiasis, and iatrogenic injury. Median followup was 363 days. Three patients had Clavien-Dindo class III complications during their hospitalization. No patient required repeat intervention due to recurrent ureteral stricture disease. On imaging, nine patients had no obstruction on Lasix renal scan postoperatively, or improvement in hydronephrosis on CT scan. Two patients with poor renal function preop continued to show poor function after surgery. CONCLUSIONS The use of the appendix is a safe and feasible option for ureteral reconstruction in appropriately selected adult patients when primary ureteral repair is not possible.