The ureter was a tube that will drains the urine from the kidney down to the bladder. In some cases, a portion of the ureter will be narrowed, which was called as stricture. This may be congenital, or the result of scarring from the earlier surgery, urinary stones and may be of other causes. Ureteral stricture usually requires complex reconstruction to restore the ureter to the normal drainage pathway. Alternative drainage procedures may be used, like tube drainage from the ureteral stenting and kidney (nephrostomy) to protect the kidney.
CAUSES:
Variety of causes, that may includes radiation therapy, stone passage, penetrating traumatic injuries, endoscopic urologic procedures and open or laparoscopic surgery. The occurrence of the ureteral strictures was increased rapidly in recent years, mainly as a result of the introduction and extensive use of upper urinary tract endoscopy. Main factors can contribute to the development of ureteral strictures subsequent ureteroscopy, which can be observed in as many as 3% to 11% of the patients. This includes stone impaction, relative ischemia, ureteral injury with extravasation of urine, thermal trauma, usually because of the utilize of larger instruments for extended intervals and direct mechanical. Ureteral injury leading to fistula formation, stricture or obstruction can also been seen by following a variety of open treatment methods, including vaginal and abdominal hysterectomy, pelvic exploration in patients with colon repair of vascular lesions and prostate and rectal malignancies.
SYMPTOMS:
Symptoms of ureteral strictures may include flank pain and fever, abdominal pain, vomiting, nausea, infection, and sometimes an overall sensation that not feeling well.
DIAGNOSIS:
Medical history and then they may perform a variety of diagnostic tests to rule out various causes. Doctor will observe the stricture by using X-rays, CT scan, ureteroscopy, ultrasound, retrograde pyelogram or nephrostogram or MRI. If doctor may determine that a tumor may be present, additional tests are required to confirm whether if it was malignant or benign.
