Abstract
PurposeThere are few reports about balloon dilatation combined with internal and external drainage tube in the treatment of ureteral stricture under interventional therapy. The aim of the study is to explore the safety, effectiveness and long-term efficacy of this treatment strategy.Materials and methodsIt is a retrospective and observational study. From October 2013 to October 2016, 42 patients with benign lower ureteral stricture received interventional treatment. Balloon dilatation combined with internal and external drainage tube implantation were used. There were 25 male patients and 17 female patients. There were 7 cases (16.7%) with congenital ureteral stricture, 12 cases (28.6%) with inflammation, 15 cases (35.7%) with ureteral stricture after lithotomy or lithotripsy, and 8 cases (19.0%) with ureteral stricture after pelvic or abdominal surgery. After the drainage tube was removed, B ultrasound, enhanced CTU or IVP of urinary system were reexamined every six months. The follow-up time was 12–60 months.ResultsThe age was 52.9 ± 11.6 years. The length of ureteral stricture was 1.1 ± 0.5 cm. 42 patients completed interventional treatment, the technical success rate was 100%, no ureteral perforation, rupture or other complications were identified. Preoperative urea nitrogen 9.2 ± 2.3 mmol/L and creatinine 175.8 ± 82.8umol/L. Urea nitrogen and creatinine were 3.8–9.1 mmol/L and 45.2–189.6 umol/L when removing the drainage tube. There were significant differences in the levels of urea nitrogen and creatinine before and after tube removal (P < 0.05). The ureteral patency rate was 100% at 6 months, 93% at 12 months, 83% at 18 months, 79% at 24 months, 76% at 30 months and 73% at 36–60 months. The overall success rate was 73%. Multivariate Cox regression analysis showed that stenosis length was a risk factor for postoperative patency (P < 0.05).ConclusionBalloon dilatation combined with internal and external drainage tube implantation in the treatment of benign lower ureteral stricture is safe and effective.
Highlights
Ureteral stricture is a relatively rare urinary system disease, which refers to ureteral stenosis caused by various reasons, eventually leading to hydronephrosis or renal failure [1]
There were few reports of balloon dilatation combined with internal and external drainage tube in the treatment of ureteral stricture under interventional therapy, and the observation of long-term therapeutic effect of balloon dilatation is scarce in the literature
This study retrospectively collected the data of patients with ureteral stricture treated by balloon dilatation combined with internal and external drainage tube in the Interventional Therapy Department of our hospital, to analyse the safety, effectiveness and long-term efficacy of this treatment method
Summary
Ureteral stricture is a relatively rare urinary system disease, which refers to ureteral stenosis caused by various reasons, eventually leading to hydronephrosis or renal failure [1]. The causes of secondary ureteral stricture include calculus, inflammation, injury after lithotripsy [2], ureteral related operation, tumor invasion, retroperitoneal fibrosis, iatrogenic injury caused by abdominal and pelvic surgery, radiotherapy, etc. Used treatments for ureteral strictures include open surgery and minimally invasive treatment. There were few reports of balloon dilatation combined with internal and external drainage tube in the treatment of ureteral stricture under interventional therapy, and the observation of long-term therapeutic effect of balloon dilatation is scarce in the literature. This study retrospectively collected the data of patients with ureteral stricture treated by balloon dilatation combined with internal and external drainage tube in the Interventional Therapy Department of our hospital, to analyse the safety, effectiveness and long-term efficacy of this treatment method
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