Endoscopic Management of Ureteral Strictures: an Update

Curr Urol Rep. 2018 Mar 2;19(4):24. doi: 10.1007/s11934-018-0773-4.

Abstract

Purpose of review: This review focuses on the role of endoscopic treatment of ureteral stricture disease (USD) in the era of minimally invasive surgery.

Recent findings: There is a relative paucity of recent literature regarding the endoscopic treatment of USD. Laser endopyelotomy and balloon dilation are associated with good outcomes in treatment-naïve patients with short (< 2 cm), non-ischemic, benign ureteral strictures with a functional renal unit. If stricture recurs, repetitive dilation and laser endopyleotomy is not recommended, as success rates are low in this scenario. Patients with low-complexity ureteroenteric strictures and transplant strictures may benefit from endoscopic treatment options, although formal reconstruction offers higher rates of success. Formal ureteral reconstruction remains the gold-standard treatment for ureteral stricture disease as it is associated with higher rates of complete resolution. However, in carefully selected patients, endoscopic treatment modalities provide a low-cost, low-morbidity alternative.

Keywords: Balloon dilation; Endoscopy; Laser; Stents; Ureteral stricture.

Publication types

  • Review

MeSH terms

  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / surgery
  • Dilatation
  • Humans
  • Kidney Pelvis / surgery
  • Kidney Transplantation / adverse effects
  • Recurrence
  • Ureteral Obstruction / etiology
  • Ureteral Obstruction / surgery*
  • Ureteroscopy / methods*