Ureteral stricture

Ureteral Stricture – an abnormal narrowing of the ureter channel that partially or completely disrupts its patency. In areas above the stricture, due to urine stagnation, pressure on the ureter increases, leading to its dilation, elongation, and tortuosity; possible expansion of the renal pelvis and development of hydronephrosis (ureterohydronephrosis).

Causes:

• gynecological surgeries (ligation, trauma);
• iatrogenic injuries;
• pressure sores from stones;
• radiation damage.

Symptoms

The clinical picture of ureteral stricture is determined by the disruption of free urine flow from the kidney and the development of various pathological processes against this background: hydronephrosis, pyelonephritis, urolithiasis; in cases of bilateral involvement — chronic renal failure.

Diagnosis:

• Ultrasound of the kidneys
• CT of the kidneys
• MRI

Treatment

Ureteral stricture is an absolute indication for surgical treatment, the choice of which is determined by the structural and functional state of the ureters and kidneys, the length and level of the stenosis. In cases of minimal kidney tissue involvement, various reconstructive surgeries of the corresponding section of the ureter are performed, aimed at eliminating the narrowing of the duct and restoring free urine flow from the renal calyx-pelvic system.

Laparoscopic ureterocystostomy.

Endoureteral laser incision of the stricture.

Intestinal replacement plastic of the ureter.