Bladder cancer is one of the most common urological malignancies, with 25 % of patients having muscle-invasive disease [1]⁠. The primary surgical intervention for non-metastatic muscle invasive bladder cancer is radical cystectomy and urinary diversion. Despite a century-long history of this procedure, a definitive consensus regarding the optimal urinary diversion method remains elusive. Nevertheless, the ileal conduit stands out as one of the most frequently employed urinary diversion techniques following radical cystectomy [2,3]⁠. A pivotal step in urinary diversion involves the ureteroileal anastomosis, which occurs after isolating the ileal segment. The most commonly employed anastomosis techniques are the Bricker, Wallace, and Hybrid methods (Fig. 1).

In the Bricker technique, the left ureter is transposed to the contralateral side through a retrosigmoid tunnel. Subsequently, both ureters are spatulated, and each ureter is individually anastomosed to the anti-mesenteric wall of the ileal conduit [4]⁠. The Wallace anastomosis involves the spatulation of both ureters, followed by their anastomosis with each other. This occurs after the left ureter is transposed to the contralateral side through the same retrosigmoid tunnel, resulting in the creation of a single ureteric plate, which is then anastomosed to the proximal lumen of the ileal conduit [5]⁠. In the Hybrid technique, the right ureter is anastomosed to the anti-mesenteric wall of the ileal conduit, similar to the Bricker technique. Meanwhile, the left ureter is transposed via the retrosigmoid tunnel, and the spatulated left ureter is anastomosed alone to the proximal lumen of the ileal conduit akin to wallace technique.

The literature reports a wide range of incidence for ureterointestinal anastomosis stricture, spanning from 1.9 % to 25.3 % [6,7]⁠. We posit that this range may be attributed to the specific anastomosis technique employed. While the Bricker and Wallace techniques have been compared extensively in the literature, no comparative study includes the Hybrid technique, except for a single study with a small number of patients [8]⁠. In this study, our objective is to compare the Bricker, Wallace, and Hybrid ureteroileal anastomosis types in terms of stricture development.