Analysis of long-term effect of ureteral balloon dilatation combined with internal and external drainage tube in the treatment of benign ureteral stricture

Abstract

Purpose There are few reports about balloon dilatation combined with internal and external drainage tube in the treatment of ureteral stricture under interventional therapy. The aim of the study is to explore the safety, effectiveness and long-term efficacy of this treatment strategy. Materials and methods It is a retrospective and observational study. From October 2013 to October 2016, 42 patients with benign lower ureteral stricture received interventional treatment. Balloon dilatation combined with internal and external drainage tube implantation were used. There were 25 male patients and 17 female patients. There were 7 cases (16.7%) with congenital ureteral stricture, 12 cases (28.6%) with inflammation, 15 cases (35.7%) with ureteral stricture after lithotomy or lithotripsy, and 8 cases (19.0%) with ureteral stricture after pelvic or abdominal surgery. After the drainage tube was removed, B ultrasound, enhanced CTU or IVP of urinary system were reexamined every six months. The follow-up time was 12–60 months. Results The age was 52.9 ± 11.6 years. The length of ureteral stricture was 1.1 ± 0.5 cm. 42 patients completed interventional treatment, the technical success rate was 100%, no ureteral perforation, rupture or other complications were identified. Preoperative urea nitrogen 9.2 ± 2.3 mmol/L and creatinine 175.8 ± 82.8umol/L. Urea nitrogen and creatinine were 3.8–9.1 mmol/L and 45.2–189.6 umol/L when removing the drainage tube. There were significant differences in the levels of urea nitrogen and creatinine before and after tube removal (P < 0.05). The ureteral patency rate was 100% at 6 months, 93% at 12 months, 83% at 18 months, 79% at 24 months, 76% at 30 months and 73% at 36–60 months. The overall success rate was 73%. Multivariate Cox regression analysis showed that stenosis length was a risk factor for postoperative patency (P < 0.05). Conclusion Balloon dilatation combined with internal and external drainage tube implantation in the treatment of benign lower ureteral stricture is safe and effective.

Renal function after ureteral reconstruction surgery in patients with solitary kidney

“…Ureteral strictures (US) are associated with severe hydronephrosis, leading to the impairment of kidney function, which commonly manifests as flank pain and urinary retention ( 1 - 3 ). To alleviate obstruction and preserve renal function, ureteral reconstruction surgeries may be used to treat US.…”

Analysis of the Efficacy and Risk Factors for Failure of Balloon Dilation for Benign Ureteral Stricture

“…Advances in endoscopic technology have provided urologists with an alternative to reconstructive surgery in the treatment of ureteral stricture [ 5 , 6 , 7 ]. Balloon dilation is one of the most common endoluminal treatment modalities for ureteral stricture [ 8 , 9 , 10 , 11 , 12 ]. Despite the fact that balloon dilation has a higher rate of stricture recurrence than reconstructive ureteral surgery, it is less invasive and has fewer complications, and its short-term treatment results are good, making it widely used in clinical practice [ 13 , 14 , 15 ].…”