Muco-mucosal anastomotic non-transecting augmentation (MANTA) ureteroplasty

Introduction & Objectives: Revision ureteric reconstruction is often very challenging due to limited ureteric length and compromised blood supply. We aimed to describe a technique of a non-transecting augmentation ureteroplasty with buccal mucosal graft for a patient with a recurrent ureteri...

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Main Authors: Jonathan Kam, Anthony Emmanuel, Francesco Del Giudice, Majed Shabbir, Rajesh Nair
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Urology Video Journal
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590089724000598
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author Jonathan Kam
Anthony Emmanuel
Francesco Del Giudice
Majed Shabbir
Rajesh Nair
author_facet Jonathan Kam
Anthony Emmanuel
Francesco Del Giudice
Majed Shabbir
Rajesh Nair
author_sort Jonathan Kam
collection DOAJ
description Introduction & Objectives: Revision ureteric reconstruction is often very challenging due to limited ureteric length and compromised blood supply. We aimed to describe a technique of a non-transecting augmentation ureteroplasty with buccal mucosal graft for a patient with a recurrent ureteric stricture. This technique was adapted from the urethroplasty literature and applied to upper tract reconstruction. Methods: A 70 year old male had previously underwent a diverticulectomy and boari flap reimplantation for urothelial cancer. The anastomosis strictured and a revision ureteric reimplantation was performed which also subsequently strictured. A stent was not able to be placed across the stricture so the patient was nephrostomy dependent. A buccal mucosal graft augmentation was performed using a muco-mucosal anastomotic non-transecting augmentation (MANTA) technique adapted from the urethroplasty literature Results: The patient recovered well and was discharged day 3. A cystogram was performed and catheter removed at 4 weeks. The stent was removed at 6 weeks and a retrograde pyelogram showed a normal ureteric caliber. A MAG-3 renogram at 3 months showed no obstruction Conclusions: We describe a novel technique for difficult revision upper tract reconstruction cases.
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spelling doaj-art-cbfb99f3bd2f4f0ab7bebd56a9c6d5ba2025-08-20T02:36:09ZengElsevierUrology Video Journal2590-08972025-03-012510032010.1016/j.urolvj.2024.100320Muco-mucosal anastomotic non-transecting augmentation (MANTA) ureteroplastyJonathan Kam0Anthony Emmanuel1Francesco Del Giudice2Majed Shabbir3Rajesh Nair4Department of Urology, Guys Hospital, London, UKDepartment of Urology, Guys Hospital, London, UKDepartment of Urology, Guys Hospital, London, UKDepartment of Urology, Guys Hospital, London, UKCorresponding author.; Department of Urology, Guys Hospital, London, UKIntroduction & Objectives: Revision ureteric reconstruction is often very challenging due to limited ureteric length and compromised blood supply. We aimed to describe a technique of a non-transecting augmentation ureteroplasty with buccal mucosal graft for a patient with a recurrent ureteric stricture. This technique was adapted from the urethroplasty literature and applied to upper tract reconstruction. Methods: A 70 year old male had previously underwent a diverticulectomy and boari flap reimplantation for urothelial cancer. The anastomosis strictured and a revision ureteric reimplantation was performed which also subsequently strictured. A stent was not able to be placed across the stricture so the patient was nephrostomy dependent. A buccal mucosal graft augmentation was performed using a muco-mucosal anastomotic non-transecting augmentation (MANTA) technique adapted from the urethroplasty literature Results: The patient recovered well and was discharged day 3. A cystogram was performed and catheter removed at 4 weeks. The stent was removed at 6 weeks and a retrograde pyelogram showed a normal ureteric caliber. A MAG-3 renogram at 3 months showed no obstruction Conclusions: We describe a novel technique for difficult revision upper tract reconstruction cases.http://www.sciencedirect.com/science/article/pii/S2590089724000598Upper tract reconstructionUreteroplastyUreteric strictureBuccal mucosa graftAugmentation ureteroplasty
spellingShingle Jonathan Kam
Anthony Emmanuel
Francesco Del Giudice
Majed Shabbir
Rajesh Nair
Muco-mucosal anastomotic non-transecting augmentation (MANTA) ureteroplasty
Urology Video Journal
Upper tract reconstruction
Ureteroplasty
Ureteric stricture
Buccal mucosa graft
Augmentation ureteroplasty
title Muco-mucosal anastomotic non-transecting augmentation (MANTA) ureteroplasty
title_full Muco-mucosal anastomotic non-transecting augmentation (MANTA) ureteroplasty
title_fullStr Muco-mucosal anastomotic non-transecting augmentation (MANTA) ureteroplasty
title_full_unstemmed Muco-mucosal anastomotic non-transecting augmentation (MANTA) ureteroplasty
title_short Muco-mucosal anastomotic non-transecting augmentation (MANTA) ureteroplasty
title_sort muco mucosal anastomotic non transecting augmentation manta ureteroplasty
topic Upper tract reconstruction
Ureteroplasty
Ureteric stricture
Buccal mucosa graft
Augmentation ureteroplasty
url http://www.sciencedirect.com/science/article/pii/S2590089724000598
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AT anthonyemmanuel mucomucosalanastomoticnontransectingaugmentationmantaureteroplasty
AT francescodelgiudice mucomucosalanastomoticnontransectingaugmentationmantaureteroplasty
AT majedshabbir mucomucosalanastomoticnontransectingaugmentationmantaureteroplasty
AT rajeshnair mucomucosalanastomoticnontransectingaugmentationmantaureteroplasty