Editing Ureteric Stricture Disease (section)

====Endourologic procedures====
*'''<span style="color:#ff0000">Best management for ureteral strictures < 2 cm with no previous intervention is an endoscopic approach</span>'''

===== Contraindications (1): =====
#'''<span style="color:#ff0000">Strictures >2cm</span>''' because dilation alone is unlikely to be successful

===== Options (2): =====

# '''<span style="color:#ff0000">Balloon dilation</span>'''
# '''<span style="color:#ff0000">Endoureterotomy</span>'''

====== Balloon dilation ======
*Efficacy
**Success rates range from 50-76%, long-term outcomes are unfavorable
**'''Best results obtained in patients with iatrogenic, non-anastomotic strictures such as those secondary to ureteroscopic instrumentation'''. In that setting, a success rate of 85% was achieved compared with a rate of 50% for anastomotic strictures
*Technique
**After 10 minutes of tamponade, the balloon is deflated and withdrawn. 
**An internal stent is passed over a guidewire still in place, which is left indwelling for 2-4 weeks.
*'''Post-operative follow-up'''
**'''Diuretic renography''' is usually performed ≈1 month after stent extraction and at 6- to 12-month intervals thereafter

====== Endoureterotomy ======
*'''<span style="color:#ff0000">Technique</span>'''
**'''<span style="color:#ff0000">Incision</span>'''
***'''<span style="color:#ff0000">Position is chosen as a function of the level of the ureter involved. In general</span>'''
****'''Lower ureteral strictures are incised in an anteromedial direction to stay away from the iliac vessels'''
****'''Upper ureteral strictures are incised laterally or posterolaterally'''
***Can be performed using a cold knife, a cutting electrode, or a holmium laser