Electrocautrey endoureterotomy combined with Balloondilation for Ureteral stricture

Abstract

Objective To evaluate the efficacy and safety of electrocautrey endoureterotomy combined with balloon dilation for ureteral stricture. Methods From May 2007 to March 2016, 469 cases of ureteral stricture were treated by electrocautrey endoureterotomy combined with balloon dilation in our hospital. The safe guide wire was put through the ureteral stricture retrogradely, anterogradely or bilaterally. The stricture was cut through transmurally by electrocautery, and was dilated ulteriorly by 21F balloon. Double J tube was indwelled. The efficaly was assessed by regular follow-up. Results All 469 cases included 370 retrograde cases, 50 anterograde cases and 49 bilateral cases. One patient of renal transplantation occurred massive hemorrhage when urinary bladder junction was incised, and converted to open surgery to hemostasis. Long-term replacement stent was the treatment for this case. Five cases with ureteropelvic junction obstruction had hemorrhage, which were treated successfully by conservative treatment. 381 cases had one year follow-up, 275 cases (72.2%) had primary surgical success. Stricture recurrence occurred in 106 cases, 57 cases were cured by 2-5 times endoscopic stenosis dilation, 5 cases were converted to open surgery, 13 cases were cured by metal mesh stent implantation, 17 cases needed long-term regular replacement of double J tube, 8 patients needed long-term indwelling renal fistula, 6 cases needed nephrectomy. Conclusion Electrocautrey endoureterotomy combined with balloondilation in the treatment of ureteral stricture is safe, reliable and effective, especially for the patients with short, mild stricture and better renal function. Key words: Ureteral stricture; Electrocautrey endoureterotomy; Balloondilation; Effect