Thulium Fiber Laser–Assisted Endoureterotomy for Treatment of Complete Obliterative Uretero‐Ileal Conduit Anastomotic Stricture in a Patient With Ureteral Duplication: A Case Report

One of the known complications of radical cystectomy with urinary diversion is the development of a benign ureteroenteric anastomotic stricture (UES), which can lead to hydronephrosis and renal dysfunction. Holmium:YAG lasers are commonly used for endoscopic management of these UES. Recently, thulium fiber lasers (TFLs) have shown promise in managing benign ureteral strictures due to their superior ablation qualities. We present the first reported case of successful TFL‐assisted endoureterotomy for a UES in a patient with a complete left ureteral duplication following RARC and ileal conduit urinary diversion. The patient developed symptomatic left lower moiety hydronephrosis, which was managed with antegrade ureteroscopy and TFL incision and ablation of a complete, obliterative, short segment stricture. An endoureterotomy stent was placed, and she had resolution of both symptoms and hydronephrosis. This case highlights TFL as a viable minimally invasive option for managing complex UES, including patients with anatomical variants such as ureteral duplication.