Holmium Laser Endoureterotomy for Benign Ureteral Stricture: A Single Center Experience

Abstract

Holmium laser endoureterotomy is effective for benign ureteral stricture in well selected patients. Most failures occur within less than 9 months after surgery, which may indicate a need for closer followup during postoperative year 1. Factors that might may outcome are ischemia and stricture length.

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

“…Also, endoureterotomy has been shown to be less successful in this cohort of patients and consideration for more definitive open surgical reconstruction is suggested from the onset of presentation. 8 Although radiation-induced ureteric strictures are challenging to manage, stone-related strictures comprised the majority of strictures in our series. Significant risk factors for stricture formation in this group include stone impaction greater than two months, urinary perforation, and embedded calculi within the ureteral lumen.…”

“…Reported success rates vary from 55-85%, depending on the stricture site and etiology. 8,[14][15][16][17] All eight patients undergoing endoureterotomy in our case series were treated with Ho:YAG laser. Of these, five patients One patient with recurrent ureteral stone disease was treated with uncomplicated URS and subsequently developed a distal ureteral stricture.…”

“…18,19 Success rates are higher for non-ischemic structures (not due to surgery, radiation or stone impaction), shorter strictures (≤1cm), and strictures located at the extremes of the ureter (UPJ or UVJ due to improved blood supply). 4,8 Poor ipsilateral renal function (<25%) appears to negatively impact endoureterotomy success rates.…”

Acucise® Endoureterotomy: A Forgotten Treatment Option in Ureteral Strictures of Benign Origin between the Ureteropelvic and Ureterovesical Junctions; Long-Term Results

“…Hot knife incision was performed with overall success rate of 62-86% but complications and follow-up were not clearly described in all studies [17][18][19]. Laser endoureterotomy shows a 61-89% success rate and complications are rare [20][21][22][23]. …”

Lactante con estenosis de uréter medio congénito tratado endourológicamente

“…Aunque es posible que la pielografía anteró grada aporte ventajas sobre la retró grada al poder valorar mejor la resistencia al paso del contraste por la unió n ureterovesical y disminuir la agresió n sobre ella 5 , esta implica un abordaje percutá neo del riñ ó n, el cual pensamos no es fá cil de realizar en lactantes y aporta una morbilidad asociada no despreciable. Por ello, nosotros preferimos la pielografía retró grada mediante el uso de tutores ureterales de bajo perfil (3 o 4 Fr).…”