Endourological autologous bypass-ureteroplasty for anastomotic atresia in orthotopic neobladder: a novel surgical approach and case report

Ao Li^1,#, Cai Tang^2,#, Xin Wei^3,*, Feng Liu^1,*
1 Department of Pediatric Urology, Sichuan University West China Second University Hospital, Chengdu, 610041, China
2 Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, 610041, China
3 Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, 610041, China
* Corresponding Author: Xin Wei. Email: email ; Feng Liu. Email: email
# These authors contributed equally to this work
(This article belongs to the Special Issue: Decoding Renal Development: From Molecular Blueprints to Reconstructive Innovations)

Canadian Journal of Urology https://doi.org/10.32604/cju.2025.070366

Received 14 July 2025; Accepted 15 September 2025; Published online 27 October 2025

Abstract

Background: Ureteroenteric anastomotic stricture is a common complication after ureteral diversion with radical cystectomy, which leads to hydronephrosis, infection, and chronic renal failure. Although ureteroneocystostomy is reliable, its high degree of invasion often causes great damage and postoperative complications in patients. Therefore, we offer a new endoscopic approach with relatively limited invasion for severe obstructions such as ureteroenteric anastomotic atresia. Case Description: A 65-year-old man underwent radical cystectomy and urinary diversion of orthotopic neobladder and standardized chemotherapy for high-risk non-muscle-invasive bladder cancer. Severe left hydronephrosis was then detected due to ureteroenteric anastomotic atresia. Percutaneous nephrostomy was performed to preserve renal function. Based on our previous experience in ureteral bypass construction utilizing the Allium ureteral stent, the patient received a successful endourological autologous bypass-ureteroplasty to treat ureteroenteric anastomotic atresia in an orthotopic neobladder and maintained mild hydronephrosis with a stent-free in the follow-up. Conclusions: The case offers an innovative and promising surgical modality to overcome the limitations of the existing endourological techniques, which often require long-term placement of ureteral stents to maintain drainage and are associated with stent-related symptoms. Compared to traditional ureteroneocystostomy, endoscopic treatment offers advantages such as minimal invasiveness and fewer postoperative complications. With advancements in related techniques, endoscopic management has become a promising alternative for selected cases.