Urology Journal

ISSN: 1735-1308

March-April 2022
Vol. 19 No. 02 (2022)

Risk Factors for Failure of Endoscopic Management of Stone-related Ureteral Strictures

Urology Journal, Vol. 19 No. 02 (2022), , Page 95-100
https://doi.org/10.22037/uj.v18i.6697

Abstract

Purpose: To investigate factors determining the outcomes of endoscopic management for stone-related ureteral stricture.
Materials and Methods: Data of patients who underwent endoscopic surgery for ureteral stricture due to stones from January 2016 to April 2020 were retrospectively analyzed. We compared cases successfully treated with endoscopic surgery with cases that resulted in failure. We focused on factors associated with treatment success, including cause and length of stricture, methods of stricture treatment, surgical time, and duration of hydronephrosis before the treatment. Treatment success was defined as improvement in hydronephrosis status.
Results: Nineteen patients were treated for stone-related ureteral stricture. Hydronephrosis was successfully improved in 12 patients (63.2%). Seven patients with failed endoscopic management had ureteroscopic lithotripsy- related stricture, whereas 3/12 (25.0%) patients with ureteroscopic lithotripsy-related stricture and 7/12 (58.3%) patients with impacted stone-related stricture were successfully treated by endoscopic management (P = .004). The prevalence of stricture length > 15 mm was significantly higher in the patients with failed management than in the patients with successful management (71.4 vs 16.6%, P = .046). Intraoperative endoscopic observation demonstrated that the mucosa of the ureteroscopic lithotripsy-related stricture had ischemic appearance with relatively long stricture length (P = 0.13) compared to the impacted stone-related stricture. No association was observed between treatment outcome and method of endoscopic management, including laser incision, balloon dilation, or
both.
Conclusion: Ureteroscopic lithotripsy as a cause and stricture length > 15 mm could affect the success rate of
endoscopic management of ureteral stricture. In such cases, reconstructive management should probably be considered in the early stages.

Keywords:
  • ureteroscopy, ureteral stricture, impacted stones, hydronephrosis

How to Cite

Sugino, T., Taguchi, K., Hamamoto, S., Okada, T., Isogai, M., Tanaka, Y., Unno, R., Fujii, Y., Hamakawa, T., Ando, R., Okada, A., & Yasui, T. (2021). Risk Factors for Failure of Endoscopic Management of Stone-related Ureteral Strictures. Urology Journal, 19(02), 95-100. https://doi.org/10.22037/uj.v18i.6697

References

Curhan GC. Epidemiology of stone disease. Urol Clin North Am. 2007;34:287-93.

Ando R, Nagaya T, Suzuki S, et al. Kidney stone formation is positively associated with conventional risk factors for coronary heart disease in Japanese men. J Urol. 2013;189:1340-6.

Preminger GM, Tiselius HG, Assimos DG, et al. 2007 guideline for the management of ureteral calculi. J Urol. 2007;178:2418-34.

Taguchi K, Cho SY, Ng AC, et al. The Urological Association of Asia clinical guideline for urinary stone disease. Int J Urol. 2019;26:688-709.

Geavlete P, Georgescu D, Nita G, et al. Complications of 2735 retrograde semirigid ureteroscopy procedures: a single-center experience. J Endourol. 2006;20:179-85.

Gdor Y, Gabr AH, Faerber GJ, et al. Success of laser endoureterotomy of ureteral strictures associated with ureteral stones is related to stone impaction. J Endourol. 2008;22:2507-11.

Roberts WW, Cadeddu JA, Micali S, et al. Ureteral stricture formation after removal of impacted calculi. J Urol. 1998;159:723-26.

Fam XI, Singam P, Ho CCK, et al. Ureteral stricture formation after ureteroscope treatment of impacted calculi: a prospective study. Korean J Urol. 2015;56:63-7.

Razdan S, Silberstein IK, Bagley DH. Ureteroscopic endoureterotomy. BJU Int. 2005;95:94-101.

Ramanathan R, Kumar A, Kapoor R, et al. Relief of urinary tract obstruction in tuberculosis to improve renal function: analysis of predictive factors. Br J Urol. 1998;81:199-205.

Lang EK, Fritzsche PF. Ureteral strictures. In: Lang EK, editor. Radiology of the lower urinary tract. Berlin: Springer-Verlag; 1994. p. 33-40.

May PC, Hsi RS, Tran H, et al. The morbidity of ureteral strictures in patients with prior ureteroscopic stone surgery: multi-institutional outcomes. J Endourol. 2018;32:309-14.

Kanda Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant. 2013;48:452-8.

Richter F, Irwin RJ, Watson RA, et al. Endourologic management of benign ureteral strictures with and without compromised vascular supply. Urology. 2000;55:652-7.

Meretyk S, Albala DM, Clayman RV, et al. Endoureterotomy for treatment of ureteral strictures. J Urol. 1992;147:1502-6.

Dretler SP, Young RH. Stone granuloma: a cause of ureteral stricture. J Urol. 1993;150:1800-2.

Netto Júnior NR, Ferreira U, Lemos GC, et al. Endourological management of ureteral strictures. J Urol. 1990;144:631-4.

Thomas R. Choosing the ideal candidate for ureteroscopic endoureterotomy. J Urol. 1993;149:314A.

Byun SS, Kim JH, Oh SJ, et al. Simple retrograde dilation for treatment of ureteral strictures: etiology-based analysis. Yonsei Med J. 2003;44:273-8.

Wolf JS Jr, Soble JJ, Ratliff TL, et al. Ureteral cell cultures II. Collagen production and response to pharmacologic agents. J Urol. 1996;156:2067–72.

Singal RK, Denstedt JD, Razvi HA, et al. Holmium: YAG laser endoureterotomy for treatment of ureteral stricture. Urology. 1997;50:875-80.

Lane BR, Desai MM, Hegarty NJ, et al. Long-term efficacy of holmium laser endoureterotomy for benign ureteral strictures. Urology. 2006;67:894-7.

Schondorf D, Meierhans-Ruf S, Kiss B, et al. Ureteroileal strictures after urinary diversion with an ileal segment-is there a place for endourological treatment at all? J Urol. 2013;190:585-90.

Laven BA, O'Connor RC, Gerber GS, et al. Long-term results of endoureterotomy and open surgical revision for the management of ureteroenteric strictures after urinary diversion. J Urol. 2003;170:1226-30.

Johnson DE, Cromeens DM, Price RE. Transurethral incision of the prostate using the holmium: YAG laser. Lasers Surg Med. 1992;12:364-9.

Shields JM, Bird VG, Graves R, et al. Impact of preoperative stenting on outcome of ureteroscopic treatment for urinary lithiasis. J Urol. 2009;182:2768-74.

Liu JS, Hrebinko RL. The use of 2 ipsilateral ureteral stents for relief of ureteral obstruction from extrinsic compression. J Urol. 1998;159:179-81.

Christman MS, Kalmus A, Casale P. Morbidity and efficacy of ureteroscopic stone treatment in patients with neurogenic bladder. J Urol. 2013;190:1479-83.

Ibrahim HM, Mohyelden K, Abdel-Bary A, et al. Single versus double ureteral stent placement after laser endoureterotomy for the management of benign ureteral strictures: a randomized clinical trial. J Endourol. 2015;29:1204-9.

Isogai M, Hamamoto S, Hasebe K, et al. Dual ureteral stent placement after redo laser endoureterotomy to manage persistent ureteral stricture. IJU Case Rep. 2020;3:93-5.

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