Ureteral and Ureteroenteric Strictures

Shah, Ojas; Marien, Tracy

doi:10.1007/978-1-62703-206-3_5

Cited by 1 publication

(2 citation statements)

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“…A ureteral stricture is a narrowing of the ureter causing functional obstruction 1 . This may cause pain, lead to a deterioration in renal function and hinder ureteral stones from passing spontaneously.…”

Section: Introductionmentioning

confidence: 99%

“…It may also act as an obstacle for passage of an endoscope. Ureteroscopy (URS) is a known iatrogenic cause of strictures and risk factors in conjunction with this procedure include perforations and excessive operating time 1,2 . In addition, URS performed by an inexperienced surgeon has been shown to increase the risk of complications 3,4 .…”

Section: Introductionmentioning

confidence: 99%

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Ureteral Strictures Following Ureteroscopic Stone Treatment

Ulvik

Harneshaug

Gjengstø

2021

Journal of Endourology

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Background and purpose: Ureteral stricture is a rare, but serious complication following ureteroscopy (URS) for stones. The aim of this study was to investigate how many patients ended up with a ureteral stricture after URS at our hospital and how these were treated. We also wanted to identify potential risk factors for post endoscopic stricture formation. Materials and methods:A retrospective evaluation of 1001 URS for stone treatment at the day-case surgery unit between 2013 -2018 was performed. Data on pretreatment status, the surgical procedure and follow-up were recorded. Exact χ 2 and independent-samples ttests were used comparing data among those who developed strictures and those who did not. Multiple logistic regression was performed analyzing risk factors for stricture formation. Results:In total, 1001 URS were performed in 725 patients, 289 women and 436 men. Of these, 995 cases were eligible for analysis. At follow-up with computed tomography after 3 months, 28 (3.0%) strictures were identified. Of these, 20 received endourological treatment with balloon dilatation of which 15 (75%) were successful. Definitive treatment in the 13 patients with failed or unattempted endourological treatment included nephrectomy, reconstructive surgery, permanent nephrostomy or observation with no further treatment.In multiple regression analysis, use of access sheath (UAS) (OR 4.6, p = 0.011), ureteral perforation (OR 11.8, p < 0.0001) and surgical time > 60 minutes (OR 5.7, p < 0.005) were found to be risk factors for stricture formation. Conclusion:Ureteral stricture is a rare complication of URS. Balloon dilatation should be the first line of treatment. Use of UAS, perforation and excessive operating time were found to be risk factors for post endoscopic ureteral stricture formation. Special attention to these risk factors should be given to reduce the incidence of ureteral strictures.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%