Management of Benign Ureteral Strictures in the Endoscopic Era

Corcoran, Anthony; Smaldone, Marc C.; Ricchiuti, Daniel D.; Averch, Timothy D.

doi:10.1089/end.2008.0453

Cited by 39 publications

(23 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Success rates of endoscopic techniques have been reported to range from 46-89% and typically have benefits of decreased morbidity and hospital stay, with shorter recovery times. [1][2][3][4][5] The objective of this study was to review our experience with benign ureteric strictures and assess the outcomes after management at our institution.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of risk factors and treatment options in patients with ureteral stricture disease at a single institution

Tran¹,

Arsovska

Paterson

et al. 2015

CUAJ

View full text Add to dashboard Cite

Introduction: Ureteral strictures are a significant cause of morbidity and mortality, resulting in potential kidney damage requiring several surgical procedures. Non-malignant causes include radiation, trauma from calculi impaction, pelvic surgery, or ureteroscopy (URS). We identified risk factors in our patients with ureteral strictures and the success of their treatment outcomes. Methods: A retrospective chart review of 25 patients with 29 ureteral strictures was performed to determine the success of their treatment. Results: Twenty-five (25) patients with 29 benign ureteral strictures were identified. Most cases (60%) were caused by impacted stones where the median stone size was 1.15 cm (0.37-1.8 cm). Intervention for stones prior to stricture development included shockwave lithotripsy, URS, and percutaneous nephrolithotomy. Five patients with strictures from impacted stones had ureteric complications during stone treatment including perforation +/-urinoma (n=3), fractured guidewire left in situ (n=1), and ureteric orifice resection (n=1). Other stricture etiologies included radiation (28%) and endometriosis (4%). Treatment modalities used included ureteroureterostomy (n=2), ureteral re-implant (n=3), urinary diversion (n=3), autotrasplant (n=1), laser endoureterotomy +/-balloon dilation (n=8), nephrectomy (n=2), balloon dilation +/-stent (n=3), ureterovesical junction (UVJ) resection + stent (n=1), chronic stent changes (n=4), or surveillance (n=3). Conclusions: Our evaluation highlights important principles. Patients with complicated ureteroscopies or severely impacted calculi warrant close followup with imaging after stone treatment due to possibility of rapid renal deterioration from stricture formation. Radiation-induced strictures are difficult to manage, possibly requiring subsequent urinary diversion. Finally, endoscopic management of benign ureteral strictures via balloon dilation and laser endoureterotomy is an excellent choice in properly selected patients, with opportunity for subsequent salvage treatments if needed.

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluation of risk factors and treatment options in patients with ureteral stricture disease at a single institution

Tran¹,

Arsovska

Paterson

et al. 2015

CUAJ

View full text Add to dashboard Cite

show abstract

“…Corcoran and colleagues have demonstrated the success of endoscopic treatment via balloon dilatation and/or laser endoureterotomy in their series of 75 patients. [15][16] Also Emiliani and colleagues found that laser endoureterotomy was successful with minimal perioperative morbidity. 16 Despite the reported success rates and low morbidities, endoscopic procedures require attention and a high level of expertise.…”

Section: Discussionmentioning

confidence: 99%

A guidewire introducer as a ureteral foreign body: A case report

Şener¹,

Cloutier²,

Audouin³

et al. 2015

CUAJ

View full text Add to dashboard Cite

A 63-year-old male, previously treated for a ureteral tumour by a right-sided segmental ureterectomy and end-to-end anastomosis of ureteral segments, was referred to our clinic for endoscopic follow-up. During his follow-up, he was diagnosed with partial right-sided ureteral stricture which eventually progressed to complete obstruction. During the ureteroscopy, as the stenotic segment did not allow passage of an hydrophilic guidewire, an antegraderetrograde approach was decided. On the antegrade endoscopic view, a near-complete stenosis was diagnosed and a nephrostomy catheter (12 Fr) was placed. A second intervention was planned and from the nephrostomy tract, the ureteroscope was placed into the right pyelocaliceal system. The diagnostic ureteroscopy revealed a foreign object proximal to the stenotic area. Right-sided segmental ureterectomy of the stenotic segment with ureteroneocystostomy and removal of the foreign object was performed. This is the only case in literature to reveal a guidewire introducer as a ureteral foreign body. This case also highlights the importance of the fragility of the ureter, the importance of the equipment, of always being watchful during a surgery, and the importance of checking the integrity of the equipment at the end of each procedure.

show abstract

“…Chez les 3 chats ayant subit une résection-anastomose urétérale, une obstruction du stent a été suspectée suite à une augmentation de taille de la cavité pyélique (17,3 ± 4,6 [12][13][14][15][16][17][18][19][20]), associée à une augmentation de la créatinémie (46,7 ± 13,2 [35-61] mg/L) et de l'urémie (154,7 ± 96,8 [66-258] mg/dL) entre 2 et 8 mois après la chirurgie. Les examens échographiques réalisés ont mis en évidence la présence de minéralisation sur le stent et à l'intérieur de celui-ci, s'avérant, après analyse, être des cristaux d'oxalate de calcium (Fig.…”

Section: Données Postopératoiresunclassified

“…Chez l'Homme, la mise en place de stents pyélico-vésicaux a permis de diminuer significativement les complications liées à une chirurgie urétérale et est utilisée de manière fréquente pour dériver les urines tant lors d'obstructions urétérales, causées par des urolithiases, que lors de lésions tumorales [16][17][18][19]. Récemment décrits en chirurgie vétérinaire lors de lithiases urétérales ou de sténose, l'utilisation de stents pyélico-vésicaux chez le chat semblerait diminuer les complications rencontrées lors de chirurgies conventionnelles [6,[20][21][22].…”

Section: Introductionunclassified