What are ureteric strictures?

The ureter is a sturdy, muscular tube that enables urine to travel from the kidney to the bladder. A urethral stricture is a condition that results in restriction of the ureter, which leads to kidney damage over time.

What are the signs of ureteric strictures?

• Pain in the region
• The formation of kidney stones
• The presence of urinary tract infections (UTIs)

What causes ureteral strictures?

Ureteral strictures may arise as a result of the following:

• Abnormalities leading to obstruction at the time of birth: An obstruction is typically diagnosed at birth. Obstructions normally form at the ureteral orifice or the ureteropelvic junction (UPJ).
• Strictures that arise due to kidney stones: The natural removal of kidney stones or surgery to treat kidney stones can lead to strictures.
• Iatrogenic: A traumatic injury may occur due to abdominal surgery. An injury to the ureter due to an operation is immediately noticed and repaired.
• Radiation therapy: Radiation therapy for cancer in the abdominal region can result in restriction of the ureter.
• Retroperitoneal fibrosis: Retroperitoneal fibrosis leads to inflammation in the area surrounding the ureter.
• Harmful obstruction: Cancer that is currently being treated or in the middle of treatment can lead to compression of the ureter, which results in obstruction.

How do you treat ureteral strictures?

Surgical repair of ureteral strictures depends on the exact location of the stricture, any previous surgeries and the reason for the stricture.

Repair options consist of the following:

• Pyeloplasty: Pyeloplasty is considered an ideal treatment for congenital ureteral obstruction at the point of the UPJ.
• Ureteroureterostomy: Ureteroureterostomy is performed for strictures that are short in length between the mid and upper ureter. The portion with the stricture is removed, and the healthy ureter is reconnected.
• Placement of a stent: A plastic or metal stent is inserted in the ureter to ensure urine bypasses the stricture. These types of stents are referred to as ureteral stents. At first, stents may be slightly uncomfortable, but patients become accustomed to these devices over time.
• Ureteroneocystostomy (UNC)/Laparoscopic ureteral reimplantation: Laparoscopic ureteroneocystostomy (UNC) involves re-implanting the ureter within the bladder.