Editing Ureteric Stricture Disease (section)

== Etiology ==

=== Classification ===

* '''<span style="color:#ff0000">Benign vs. malignant</span>'''
====Benign====
*'''<span style="color:#0000ff">SIIRRII PUF (8):</span>'''
#'''<span style="color:#0000ff">S</span><span style="color:#ff0000">tones</span>'''
#'''<span style="color:#0000ff">I</span><span style="color:#ff0000">nstrumentation, endoscopic</span>'''
#'''<span style="color:#0000ff">I</span><span style="color:#ff0000">nfection (tuberculosis)</span>'''
#'''<span style="color:#0000ff">R</span><span style="color:#ff0000">enal ablation injury</span>'''
#'''<span style="color:#0000ff">R</span><span style="color:#ff0000">adiation</span>'''
#'''<span style="color:#0000ff">I</span><span style="color:#ff0000">schemia</span>''' (trauma, surgical dissection)
#'''<span style="color:#0000ff">I</span><span style="color:#ff0000">diopathic</span>'''
#'''<span style="color:#0000ff">P</span><span style="color:#ff0000">eri</span><span style="color:#0000ff">U<span style="color:#ff0000">reteral </span><span style="color:#0000ff">F<span style="color:#ff0000">ibrosis caused by abdominal aortic aneurysm or endometriosis</span>'''
#*Endometeriosis
#**Diagnosis and Evaluation
#***History and Physical Exam
#****History
#*****Signs and Symptoms
#******May occur cyclically and include 
#*******Flank pain
#*******Dysuria
#*******Urgency
#*******Hematuria
#*******Frequent urinary tract infections
#******Most patients with ureteral obstruction associated with endometriosis are asymptomatic
#**Management
#***A trial of hormonal therapy using gonadotropin-releasing hormone agonists (Lupron) or medroxyprogesterone (Danazol) should be initiated for mild symptomatic obstruction when there is good preservation of renal function.
#***For more severe obstruction associated with significant periureteral fibrosis, surgical intervention to correct the obstruction, with or without hysterectomy and bilateral salpingo-oophorectomy, is recommended
*'''Hysterectomy accounts for over 50% of iatrogenic ureteral injuries'''
**Most likely areas where the ureter can be occluded during hysterectomy (2):
**#Level of the broad ligaments
**#At the vaginal cuff and bladder trigone
====Malignant====
*'''<span style="color:#ff0000">Intrinsic: e.g. urothelial carcinoma</span>'''
*'''<span style="color:#ff0000">Extrinsic: e.g. cervical cancer</span>'''