Impact of post-cystectomy ureteroileal stricture on renal function: justification for a protocolized follow-up
DOI:
https://doi.org/10.48193/f8vcf543Keywords:
Ureteroileal stricture, Renal function, Radical cystectomy, Glomerular filtration rate (GFR), Obstructive uropathyAbstract
Objective: to assess the impact of ureteroileal stricture (UIS) post-cystectomy on renal function and justify a protocolized follow-up.
Design: retrospective cohort study of 111 patients undergoing radical cystectomy with urinary diversion (2002-2025). Renal function was assessed via glomerular filtration rate (eGFR, CKD-EPI equation) at three timepoints: preoperative, UIS diagnosis, and post-treatment. Variables included demographics, surgical techniques, UIS management, and complications. Statistical analysis with SPSS v26 (χ², t-test, repeated-measures ANOVA, logistic regression).
Results: eGFR declined sharply from preoperative (67.7±19.4 mL/min/1.73m²) to stricture diagnosis (41.4±21.0; Δ=-26.3 mL/min; p <0.001), with partial recovery post-treatment (49.6±21.7; residual deficit: -18.1 mL/min vs. preoperative; p <0.001). Non-stricture patients maintained higher eGFR (74.9±17.6 vs. 49.6±21.7; p <0.001; d =1.31). Correlation between delayed diagnosis (>90 days) and greater eGFR loss (ρ=0.487; p=0.003).
Limitations: retrospective design, surgical heterogeneity, limited sample size for multivariate analysis.
Originality: first quantification of acute/residual renal damage after UIS, identification of a critical therapeutic window (<90 days), and justification for protocolized ultrasound surveillance.
Conclusions: UIS causes irreversible renal impairment (equivalent to 20 years of renal aging). High incidence (46 %) in laparoscopic surgery and asymptomatic presentation (67 %) support early ultrasound screening to prevent chronic kidney failure.
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