Treatment Of Ureteral Strictures Research Articles

Histology of Ureter after Unsuccessful Endoscopic Intubated Incision

Endoscopic intubated ureterotomy is used increasingly for treatment of ureteral stricture. In 3 patients with recurrent stricture after this procedure the area of ureterotomy was excised after 69, 78 and 83 days, and cut in cross section to examine the scar for muscle regeneration. A segmental scar was found consisting of collagen-rich connective tissue with few fibroblasts. Scarce smooth muscle fibers were dispersed within the scar, mostly at the edge of incision but without a regular structure.

Endourological Management of Ureteral Strictures

We reviewed the records of 20 patients (21 ureters) treated during the last 5 years for ureteral stricture disease. The causes of stricture formation included ureterolithotripsy in 47.7% of the patients, open ureterolithotomy in 9.5%, other urological procedures in 23.8%, general surgical and gynecological procedures in 9.5% and miscellaneous factors in 9.5%. A total of 20 patients (21 ureters) underwent endourological treatment with balloon dilation (19) or balloon dilation and internal ureterotomy (2), with good results in 57.1% and a mean followup of 24 months. Of the 9 patients who failed endourological management 3 underwent successful open repair, 3 underwent nephrectomy, and 3 had a relatively large ureteral lumen and became asymptomatic, receiving no further treatment. The interval between injury and treatment was not a decisive factor. The length of ureteral stricture assumes the most significant parameter to predict success in the treatment of ureteral stricture. There were no intraoperative or postoperative complications. The association of balloon dilation and incision by special endoureterotomy scissors is a potentially useful technique.

Endourologic Treatment of Ureteral Strictures

Thirty patients with ureteric strictures of various etiologies were endourologically treated. Dilatation by a balloon catheter or incision by a ureterotomy knife or a diathermy needle electrode wer...

Percutaneous Management of Benign Ureteral Strictures and Fistulas

The percutaneous methods of management of benign ureteral strictures or fistulas have developed as a natural evolution of percutaneous nephrostomy and angiographic techniques. We review our 5-year experience, which includes 18 patients with 19 benign ureteral strictures and 12 patients with ureteral fistulas. In the majority of the patients the ureteral strictures occurred at sites of surgical reconstruction or endoscopic manipulation. All fistulas resulted from surgical injury. In 10 of the 12 patients (82 per cent) the fistulas healed without development of a stricture or need for further intervention. Patients with short ureteral strictures had a high incidence of success and they usually were the best candidates for percutaneous manipulation. The longer strictures usually were of longer duration and they were less likely to be managed successfully percutaneously. Failure of percutaneous dilation did not impede subsequent surgical management. Percutaneous management often is a reasonable initial step in the treatment of ureteral strictures and fistulas.

A simple technique for the treatment of ureteral stenosis after kidney transplantation.

AbstractAn intraperitoneal approach has been used successfully in 3 patients for surgical correction of ureteral stenosis after kidney transplantation. Although the procedure cannot be used if the kidney has been transplanted in the homolateral iliac fossa, in the majority of cases it avoids the difficult dissection of the renal hilum. Thus, blood loss is minimal and the duration of the surgical procedure is shortened.

Treatment of Ureteral Strictures after Therapy for Carcinoma of the Uterus

The long term result after the operative treatment of 29 ureteral strictures by various methods in 19 patients treated radically for a malignant tumor of the uterus was evaluated an average of 50 months after the urologic reconstructive surgery. Four patients died of repeat carcinoma and one patient died of a pulmonary embolism before the follow-up examination. In the other patients, a clinical examination, isotopic nephrography, intravenous pyelography, midstream culture and sediment as well as serum creatinine assay demonstrated that transureteroureterostomy resulted in a good, or satisfactory, outcome in patients with a unilateral stricture. A similar outcome was obtained by ileal replacement of the ureter, provided renal function had not been impaired preoperatively. The results obtained with the bladder flap operation, ureterolysis and cutaneous ureterostomy were poor. The significance of early detection and active therapy for strictures is emphasized. Nonradiated tissue should be used for the reconstructive procedure.