Holmium: Yag Laser Endoureterotomy For Ureterointestinal Strictures

Watterson, James; Sofer, Mario; Wollin, Timothy A.; Nott, Linda; Denstedt, John D.

doi:10.1097/00005392-200204000-00025

Cited by 18 publications

(13 citation statements)

References 29 publications

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“…Laven and co-workers 10 reported 57% success rate in 14 renal units, with median follow-up of 20.5 months. Watterson et al 8 reported an initial 71% success rate on 23 patients, with 22 months mean follow-up, that decreased to a 56% after 3 years. These two publication report long-term patency rates that are lower than that reported for benign ureteral strictures in general.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Most of these publications include all benign ureteral strictures as a single entity, compiling a heterogeneous group of anastomotic strictures, iatrogenic surgical strictures and others. There are several reports on the efficiency of laser endoureterotomy on anastomotic strictures, either uretero-enteric or uretero-vesical, [8][9][10] but the results of Ho:YAG laser endoureterotomy in the specific setting of stone-associated strictures have not been defined. Since ureteral strictures associated with ureteral stones, especially impacted stones, might behave differently than other benign strictures this specific assessment is useful.…”

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confidence: 99%

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Success of Laser Endoureterotomy of Ureteral Strictures Associated with Ureteral Stones Is Related to Stone Impaction

Gdor

Gabr

Faerber

et al. 2008

Journal of Endourology

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Purpose: Since the holmium:yttrium-aluminum-garnet (Ho:YAG) laser is the flexible lithotrite of choice for ureteral stones, its application to ureteral strictures associated with ureteral calculi is convenient. The results of Ho:YAG laser endoureterotomy in this specific setting have not been defined. We report our experience with Ho:YAG laser endoureterotomy of ureteral strictures associated with ureteral stone treatment, with or without a history of stone impaction. Methods: We reviewed the medical records of 13 patients with ureteral stricture related to stone treatment, with (n ϭ 9) or without (n ϭ 4) a history of impacted ureteral stones, who were managed with Ho:YAG laser endoureterotomy. Follow-up was obtained with radiographic imaging and renal scans. Results: The overall success rate was 62%, with a mean follow-up of 21 months in successful cases and a mean recurrence time of 1.6 months in failures. Outcome was not associated with length or location of the stricture. Among the nine strictures associated with impacted stones, treatment was successful in only 5 (56%). Of the four strictures that occurred after stone removal but without history of impaction, the success rate was 75%. Success was also greater for strictures managed with post-procedure stents Ն8 Fr (75%), compared to stents Յ7 Fr. (56%). Conclusions: Our results suggest that laser endoureterotomy of ureteral strictures due to ureteral stone treatment without a history of impaction is associated with a reasonable success rate (75%), but that laser endoureterotomy for strictures related to impacted stones is associated with a success rate of only 56%. Larger caliber stents might be preferred in this setting. 2507

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Success of Laser Endoureterotomy of Ureteral Strictures Associated with Ureteral Stones Is Related to Stone Impaction

Gdor

Gabr

Faerber

et al. 2008

Journal of Endourology

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“…Watterson et al reported the occurrence of two failures 29 months after endoureterotomy in cases involving ureteroenteric stricture, one of which required nephroureterectomy consequent to cancer recurrence. 7 They emphasized the need for a thorough repeat evaluation including antegrade contrast studies and possible ureteroscopic visualization in order to identify an appropriate therapy.…”

Section: Discussionmentioning

confidence: 99%

Long‐term results of endoureterotomy using a holmium laser

Hibi¹,

Taki²,

Yamada³

et al. 2007

Int J of Urology

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Abstract:The long-term results of endoureterotomy using a holmium laser in cases of benign ureteral stricture, uretero-pelvic junction obstruction (UPJ-O) and ureteroenteric stricture were evaluated. Twenty procedures were carried out in 18 patients. Strictures were incised with a holmium laser using a fiber passed through the ureteroscope. Sixteen of the 20 procedures (80%) were successful at average follow-up of 60.5 months (range, 46-74). Stricture recurred in four cases. All failures occurred within 18 months. Although stricture length was not correlated with recurrence, all failures, with the exception of a single UPJ-O, involved middle ureteral strictures. Endoureterotomy using a holmium laser affords favorable results with respect to long-term patency. This procedure is recommended as a satisfactory therapeutic option for the initial management of patients presenting with ureteral stricture.

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“…Even with the periodic replacement of the single J stent, all patients stated that their quality of life was not compromised. Percutaneous and endoscopic approaches were associated in different series with a 50% to 70% success rate [7][8][9].…”

Section: Resultsmentioning

confidence: 99%

Percutaneous Ureteral Dilations for Management of Uretero-Intestinal Anastomosis Stricture following Bricker Urinary Diversion

Harrech¹

2017

UNOAJ

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Strictures of the uretero-intestinal anastomosis after urinary diversion following radical cystectomy are usually difficult to manage for both urologists and radiologists. Traditional surgery is the gold standard treatment. However, these strictures occur in oncologic patients, often old with concomitant morbidity. This makes less invasive option suitable. In this article we describe a mini invasive percutaneous option, safe and feasible under local anaesthesia, in an outpatient basis.

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Holmium: Yag Laser Endoureterotomy For Ureterointestinal Strictures

Cited by 18 publications

References 29 publications

Success of Laser Endoureterotomy of Ureteral Strictures Associated with Ureteral Stones Is Related to Stone Impaction

Success of Laser Endoureterotomy of Ureteral Strictures Associated with Ureteral Stones Is Related to Stone Impaction

Long‐term results of endoureterotomy using a holmium laser

Percutaneous Ureteral Dilations for Management of Uretero-Intestinal Anastomosis Stricture following Bricker Urinary Diversion

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