Long-Term Results of Endoureterotomy for Benign Ureteral and Ureteroenteric Strictures

No AccessJournal of UrologyClinical Urology: Original Articles1 Sep 1997Long-Term Results of Endoureterotomy for Benign Ureteral and Ureteroenteric Strictures J. Stuart Wolf, Osama M. Elashry, and Ralph V. Clayman J. Stuart WolfJ. Stuart Wolf More articles by this author , Osama M. ElashryOsama M. Elashry More articles by this author , and Ralph V. ClaymanRalph V. Clayman More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64308-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We reviewed the results of endoureterotomy for benign ureteral and ureteroenteric strictures to determine efficacy and factors associated with a successful outcome. Materials and Methods: Followup was available for 69 patients undergoing 77 endoureterotomies. Success was defined as symptomatic improvement and radiographic resolution of obstruction. Kaplan-Meier survival curves were constructed and data were analyzed with a Cox proportional hazards model. Results: None of 9 procedures in patients with the ipsilateral kidney contributing less than 25% of total renal function was successful. Among the 38 remaining benign ureteral stricture treatments with ipsilateral function 25% or greater with a median followup of 28.4 months among successful cases the 3-year success rate was 80%. No procedure failed beyond 11 months and there were 25 patients at risk beyond this point. Among the 30 remaining ureteroenteric stricture treatments with ipsilateral function 25% or greater the success rates at 1, 2 and 3 years were 73, 51 and 32%, respectively. Failures were noted during the first 36 months but none occurred later and 5 patients were at risk beyond this point. Overall, complete or tight strictures were less successfully treated. A nonischemic etiology, a stent 12F or greater and injection of triamcinolone into the bed of the incised stricture were associated with better outcome for strictures longer than 1 cm. Conclusions: Endoureterotomy of benign ureteral strictures is associated with an excellent outcome (80% success at 3 years). Endoscopic treatment of ureteroenteric strictures is less successful but still offers a reasonable first step (32% 3-year success rate). For all strictures failure is likely if ipsilateral renal function is poor. For strictures longer than 1 cm. use of a stent 12F or greater and injection of triamcinolone appear to be beneficial. References 1 : Endo-ureteroplasty with a free urothelial graft.. J. Urol.1994; 152: 910. Abstract, Google Scholar 2 : Nonparametric estimation from incomplete observations.. Amer. Stat. Ass. J.1958; 53: 457. Google Scholar 3 : Statistical Models and Methods for Lifetime Data. New York: John Wiley and Sons, Inc.1982. 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