The Outcome of Endourologic Treatment for Benign Ureteral Strictures

Hur, Dae Sun; Kim, Young Hack; Kwon, Chil Hun

Abstract

PURPOSE: We reviewed the results of endoureterotomy and balloon dilation for benign ureteral strictures to determine the efficacy of these procedures.
MATERIALS AND METHODS
We treated 19 patients who had benign ureteral stricture by retrograde endoureterotomy or balloon dilation followed by placement of a 6-8Fr stent for 6 weeks. Mean follow up period was 14 months (6-27 months). Eight patients were treated by endoureterotomy using cold knife under direct vision and 11 patients were treated by balloon dilation. The causes of ureteral strictures were abdominal surgery in 8 patients, urinary tuberculosis in 6 patients, radiation therapy in 2 patients, rigid ureteroscopy in 2 patients and periureteral abscess in 1 patient. The length of strictures was shorter than 1cm in 14 patients and over 1cm in 5 patients. The etiology of strictures was ischemic origin in 11 patients and nonischemic in 8 patients. One patient had poor ipsilateral renal function (<25%).
RESULTS
The overall success rate was 78.9% (15/19). The success rate of balloon dilation was 81.8% (9/11) and that of endoureterotomy was 75% (6/8). No significant complication such as high fever or sepsis was observed. Strictures shorter than 1cm had 92.9% (13/14) success rate while strictures over 1cm had 40% (2/5) success rate (p <0.05). The nonischemic strictures had better success rate (87.5%) compared to ischemic strictures (72.7%) without statistical significance.
CONCLUSIONS
We would suggest the use of balloon dilation or endoureterotomy as the initial treatment of benign ureteral stricture regarding the safety and efficiency. The better outcome would be expected in the strictures shorter than 1cm in length.