Genitourinary tuberculosis (GUTB) is a common extrapulmonary manifestation of tuberculosis and frequently results in ureteric strictures due to chronic inflammation and fibrosis. Upper ureteric strictures are relatively uncommon and pose significant reconstructive challenges. We report the case of a 28-year-old male with post-tubercular upper ureteric stricture and vesicoureteral reflux following completion of antitubercular therapy. After failed endoscopic management, the patient underwent open buccal mucosa graft ureteroplasty. Postoperative recovery was uneventful, and follow-up imaging demonstrated good ureteral patency with resolution of hydronephrosis. Intravenous pyelography performed four months postoperatively showed significant reduction in hydronephrosis with a patent right ureter, indicating successful graft uptake and functional improvement. At 18-month follow-up, the patient demonstrated sustained ureteral patency with favourable clinical and radiological outcomes This case highlights buccal mucosa graft ureteroplasty as a safe and effective reconstructive option for complex upper ureteric strictures secondary to GUTB.
Virmani et al. (Wed,) studied this question.